Abstract
Objective
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.
Methods
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.
Results
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).
Conclusions
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.
Objectif
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.
Méthodes
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.
Résultats
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).
Conclusions
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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Article info
Publication history
Published online: April 22, 2022
Accepted:
March 24,
2022
Received in revised form:
February 4,
2022
Received:
July 28,
2021
Identification
Copyright
© 2022 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
