Bariatric surgery may reduce cases of diabetic retinopathy in obese patients

Patients with type 2 diabetes who underwent bariatric surgery had fewer cases of all and sight-threatening diabetic retinopathy (DR) compared to obese patients who received medical management alone, according to a poster presented at AAO 2021.

In this meta-analysis, 14 studies (12 observational and 2 randomized controlled) of 362,589 patients with type 2 diabetes were included. Overall, 110,300 had undergone bariatric surgery and 252,290 patients who were medically managed were included as controls.

DR prevalence was 0.45% and 1.03% in patients who underwent surgery and patients who were medically managed, respectively. At a median of 4 years follow-up, there was a reduction in the prevalence of sight-threatening DR in patients who underwent surgery.

At a median of 8 years follow-up, patients who had bariatric surgery had a significantly lower postoperative prevalence of all DR.

Patients who had more severe DR at baseline were more likely to have worsening of DR within 12 months and progression to sight-threatening DR.

After 12 months, the bariatric surgery group had significantly fewer patients with worsened DR.

“Severity of DR at baseline was an important sign of early worsening of DR post-operatively,” the authors wrote. “Early vigilant DR screening for patients with existing STDR who undergo bariatric surgery is needed.”

Reference
Weiyang Yu C, et al. Retinal Impacts of Bariatric Surgery: A Meta-Analysis of 362,589 Patients. Presented at: AAO 2021.