Original Article| Volume 57, ISSUE 6, P370-375, December 2022

Effect of bariatric surgery on macular and peripapillary choroidal structures in young patients with morbid obesity

Published:April 22, 2022DOI:



      To examine the effect of bariatric surgery on the macular and peripapillary choroid in the late postoperative period in young patients with morbid obesity and compare them with a healthy control group.


      This prospective controlled study included 50 eyes of 25 young patients with morbid obesity and 50 eyes of 25 age and sex-matched healthy controls. Sleeve gastrectomy was performed on all patients with obesity. Preoperative and 6-month postoperative macular and peripapillary choroidal thickness, total choroidal area (TCA), luminal area (LA), and choroidal vascularity index (CVI) were performed. Results were compared with healthy controls by using enhanced depth imaging optical coherence tomography.


      Choroidal thickness and CVI values were smaller in patients with obesity in both macular and peripapillary areas compared with the healthy control group (both p < 0.001). There was a statistically significant increase in the macular and peripapillary choroidal thickness of patients with obesity when the preoperative and the postoperative 6-month values after bariatric surgery were compared (both p < 0.001). Also, it was found that bariatric surgery increased TCA and LA values in the macular and all sectors of peripapillary areas (all p < 0.001), and CVI values in the temporal and nasal peripapillary sectors (p = 0.007, p = 0.012, respectively).


      Bariatric surgery was found to increase the macular and peripapillary choroidal thickness and the nasal and temporal peripapillary CVI values in young patients with morbid obesity in the late period. To the best of our knowledge, the current study has shown for the first time that bariatric surgery affects peripapillary choroid and CVI values.


      Examiner l'effet de la chirurgie bariatrique sur la choroïde maculaire et péripapillaire pendant la période postopératoire tardive chez de jeunes patients présentant une obésité morbide, comparativement à des témoins en bonne santé.


      Il s'agit d'une étude comparative prospective portant sur 50 yeux de 25 jeunes sujets qui présentaient une obésité morbide et sur 50 yeux de 25 témoins en bonne santé appariés pour l’âge et le sexe. Tous les patients obèses ont subi une gastrectomie longitudinale. On a mesuré l’épaisseur de la choroïde maculaire et péripapillaire, la surface totale de la choroïde (STC), la zone luminale (ZL) et l'indice de vascularisation choroïdienne (CVI), tant avant l'intervention que 6 mois plus tard. Ces résultats ont été comparés à ceux de témoins en bonne santé à l'aide de la tomographie par cohérence optique à l'imagerie à profondeur améliorée.


      L’épaisseur de la choroïde et le CVI étaient plus faibles chez les patients obèses, tant dans la zone maculaire que dans la zone péripapillaire, comparativement aux sujets sains du groupe témoin (p < 0,001 pour l'ensemble des valeurs). On a enregistré une hausse statistiquement significative de l’épaisseur de la choroïde maculaire et péripapillaire chez les sujets obèses lors de la comparaison entre les valeurs préopératoires et les valeurs mesurées 6 mois après la chirurgie bariatrique (p < 0,001 pour l'ensemble des valeurs). On a également noté que la chirurgie bariatrique a augmenté les valeurs de la STC et de la ZL dans la macula et dans tous les secteurs des zones péripapillaires (p < 0,001 pour l'ensemble des valeurs), de même que le CVI dans les zones péripapillaires temporale et nasale (p = 0,007 et p = 0,012, respectivement).


      La chirurgie bariatrique accroît l’épaisseur de la choroïde maculaire et péripapillaire ainsi que le CVI dans les zones péripapillaires nasale et temporale pendant la période postopératoire tardive chez des patients jeunes qui présentent une obésité morbide. À notre connaissance, notre étude est la première à révéler un effet de la chirurgie bariatrique sur la choroïde péripapillaire et le CVI.
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