Investigating the Impact of Bariatric Surgery on Macular and Peripapillary Vessel Density in Obese Individuals without Metabolic Disease

• Published in: Ophthalmic research Vol. 67; no. 1; pp. 322 - 329
• Main Authors: Toptan, Müslüm, Elkan, Hasan
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 08.05.2024
• Subjects: Body mass index; Comparative analysis; Diseases; Germany; Investigations; Medical research; Medicine, Experimental; Obesity; Research Article; Surgery; Germany; Metabolic disease; Macular vessel density; Optical coherence tomography angiography; Retinal thickness; Bariatric surgery
• ISSN: 0030-3747; 1423-0259; 1423-0259
• DOI: 10.1159/000539103

Abstract Introduction: It is well established that microvascular structures are affected in obese people with metabolic disease. We aimed to evaluate the effect on microvascular structures by examining macular and peripapillary vessel density with optical coherence tomography angiography after bariatric surgery in obese individuals without metabolic disease. Methods: This prospective study included 96 eyes of 48 obese patients. Body mass index (BMI), macular vessel density in the superficial, intermediate, and deep capillary plexus, and peripapillary vessel density were measured before and 6 months after bariatric surgery. Results: BMI decreased significantly to 43.75 ± 4.4 kg/m2 postoperatively compared to 55.31 ± 5.1 kg/m2 preoperatively (p < 0.05). A significant increase was observed in macular vessel density in the deep capillary plexus postoperatively (p < 0.01). However, no significant postoperative increase occurred in macular vascular density in the superficial and intermediate capillary plexus (p > 0.05). Moreover, there was no change in peripapillary vascular density (p > 0.05). Postoperative thickening of the foveal, parafoveal, and perifoveal retinal layers was significant (p < 0.001). No significant correlation was detected between BMI change and macular and peripapillary vessel density changes (p > 0.05). Conclusion: An increase in macular vascular density, particularly in the deep capillary plexus, and retinal layer thickness has been observed following bariatric surgery performed on obese individuals without metabolic disease. This increase may indicate that microvascular structures are affected even in the absence of metabolic disease and that microperfusion improves with surgery.