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Russell MW, Kumar M, Li A, Singh RP, Talcott KE. Incidence of ocular pathology following bariatric surgery for with morbid obesity across a large United States National Database. Eye (Lond) 2024:10.1038/s41433-024-03088-z. [PMID: 38678114 DOI: 10.1038/s41433-024-03088-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 03/07/2024] [Accepted: 04/11/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND/OBJECTIVES Bariatric surgery, as indicated for treatment of morbid obesity, has been studied in association with short term effects on ocular pathology. However, effects of surgery on postoperative disease incidence is largely unknown. SUBJECTS/METHODS In this retrospective cohort study, the TriNetX United States Collaborative Network national database, was queried for patients with an ICD-10 code for morbid obesity and a procedural code for bariatric surgery. Patients were propensity score matched across baseline demographics at the time of surgery and compared to those presenting with an ICD10 code for morbid obesity with no records of a procedural code for bariatric surgery, identifying 42,408 patients per cohort. New diagnoses or procedural codes found after the surgical index date for diabetic retinopathy, age-related macular degeneration, glaucoma, low vision, and blindness along with pertinent treatment metrics were monitored. RESULTS Bariatric surgery was found to be associated with reduced future risk of diabetic retinopathy (RR: 0.283; 95% CI: 0.252-0.319), macular edema (RR: 0.224; 95% CI: 0.170-0.297), vitreous hemorrhage (RR: 0.459; 95% CI: 0.323-0.653), ocular hypertension (RR: 0.387; 95% CI: 0.387-0.487), glaucoma (RR: 0.360; 95% CI: 0.326-0.399), use of ocular pressure lowering medications (RR: 0.565; 95% CI: 0.496-0.644), age-related macular degeneration (RR: 0.628; 95% CI: 0.447-0.882), cataract surgery (RR: 0.524; 95% CI: 0.448-0.612), and low vision and blindness (RR: 0.328; 95% CI: 0.294-0.365) compared to patients not surgically managed. CONCLUSIONS The present analysis comprising a large US cohort of patients suggests that bariatric surgery is associated with a decreased risk of future ocular morbidity and mortality.
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Affiliation(s)
- Matthew W Russell
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA
- Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Madhukar Kumar
- Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Ang Li
- Cleveland Clinic Cole Eye Institute, Cleveland, OH, USA
| | - Rishi P Singh
- Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA
- Cleveland Clinic Cole Eye Institute, Cleveland, OH, USA
- Martin North Hospital, Cleveland Clinic, FL, USA
| | - Katherine E Talcott
- Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA.
- Cleveland Clinic Cole Eye Institute, Cleveland, OH, USA.
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Liu Y, Yao B, Chen X, Yang X, Liu Y, Xie Z, Chen X, Yuan Z, Wang X, Hu D, Ma X, Gao W, Wang R, Yang Y, Chen S, Zhang J, Song Z, Wang J, Wang J, Pei J, Wang W, Wang M, Gao J, Zhang H, Tan L, Du W, Pan X, Liu G, Du X, Hou X, Gao X, Zhang Z, Shen Z, Wu C, Yan X, Bo S, Sun X, Tang NJ, Zhang C, Yan H. Glaucoma in rural China (the Rural Epidemiology for Glaucoma in China (REG-China)): a national cross-sectional study. Br J Ophthalmol 2023; 107:1458-1466. [PMID: 35840290 DOI: 10.1136/bjo-2021-320754] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 06/29/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVE This study aimed to investigate the prevalence of glaucoma with associated factors in the rural populations of 10 provinces in China. DESIGN A population-based cross-sectional study. METHODS All participants aged 6 years or older from 10 provinces completed visual acuity testing, slit-lamp examination, ophthalmoscopy and non-contact tonometry. Glaucoma suspects underwent fundus photography, Goldmann applanation tonometry, visual field testing and gonioscopy. Glaucoma was determined according to the International Society of Geographical and Epidemiological Ophthalmology classification scheme. Associations of demographics and medical factors with glaucoma were assessed using multiple logistic regression models. RESULTS From June 2017 to October 2018, 48 398 of 52 041 participants were included in the final analyses. The age-standardised prevalence of glaucoma was 1.7% (95% CI 1.55% to 1.78%) among the participants older than 6 years, which was 2.1% (95% CI 1.93% to 2.23%) in participants aged over 40 years. The constituent ratios of glaucoma were: 44.4% primary angle-closure glaucoma (PACG), 34.7% primary open-angle glaucoma, 2.6% congenital glaucoma and 18.3% other types of glaucoma. Increasing age, smoking, cerebral stroke, type 2 diabetes, higher education (college or more) and higher personal income were significant risk factors for PACG. The unilateral and bilateral blindness rates in the entire study population were 4.692% and 1.068%, respectively. A family history of glaucoma was a significant risk factor for the prevalence of glaucoma and blindness in at least one eye. CONCLUSIONS Rural populations have a high prevalence of glaucoma, which should be included in chronic disease management programmes in China for long-term care.
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Affiliation(s)
- Yuanyuan Liu
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Baoqun Yao
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xi Chen
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin, China
| | - Xueli Yang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin, China
| | - Yong Liu
- Department of Ophthalmology, Southwest Hospital/Southwest Eye Hospital, Army Medical University, Chongqing, China
| | - Zhenggao Xie
- Department of Ophthalmology, Subei People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China
| | - Xiaofeng Chen
- Department of Ophthalmology, Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Zhigang Yuan
- Department of Ophthalmology, Shanxi Eye Hospital, Taiyuan, Shanxi, China
| | - Xingrong Wang
- Department of Ophthalmology, Eye Institute of Shandong University of Traditional Chinese Medicine, Affiliated Eye Hospital of Shandong University of TCM, Jinan, Shandong, China
| | - Dan Hu
- Department of Ophthalmology, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi, China
| | - Xiang Ma
- Department of Ophthalmology, Guyuan Municipal People's Hospital, Guyuan, Gansu, China
| | - Weiqi Gao
- Department of Ophthalmology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Ruifeng Wang
- Department of Ophthalmology, Zhengzhou Second People's Hospital, Zhengzhou, Henan, China
| | - Yuzhong Yang
- Department of Ophthalmology, Beizhen People's Hospital, Jinzhou, Liaoning, China
| | - Song Chen
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jingkai Zhang
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Zuoqing Song
- Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Junsu Wang
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jing Wang
- Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Jinyun Pei
- Department of Ophthalmology, Santan Hospital, Tianjin, China
| | - Weijuan Wang
- Department of Ophthalmology, Binhai Hospital of Tianjin Medical University General Hospital, Tianjin, China
| | - Meiyan Wang
- Department of Ophthalmology, Tianjin Haibin People's Hospital, Tianjin, China
| | - Jun Gao
- Department of Ophthalmology, Tianjin Third Central Hospital, Tianjin, China
| | - Hongwen Zhang
- Department of Ophthalmology, Tianjin Jizhou District People's Hospital, Tianjin, China
| | - Lian Tan
- Department of Ophthalmology, Southwest Hospital/Southwest Eye Hospital, Army Medical University, Chongqing, China
| | - Wei Du
- Department of Ophthalmology, Subei People's Hospital Affiliated to Yangzhou University, Yangzhou, Jiangsu, China
| | - Xuehui Pan
- Department of Ophthalmology, Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Gang Liu
- Department of Ophthalmology, Shanxi Eye Hospital, Taiyuan, Shanxi, China
| | - Xiujuan Du
- Department of Ophthalmology, Eye Institute of Shandong University of Traditional Chinese Medicine, Affiliated Eye Hospital of Shandong University of TCM, Jinan, Shandong, China
| | - Xu Hou
- Department of Ophthalmology, Xijing Hospital, Air Force Medical University, Xi'an, Shaanxi, China
| | - Xin Gao
- Department of Ophthalmology, Guyuan Municipal People's Hospital, Guyuan, Gansu, China
| | - Zhen Zhang
- Department of Ophthalmology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Zhansheng Shen
- Department of Ophthalmology, Zhengzhou Second People's Hospital, Zhengzhou, Henan, China
| | - Changfu Wu
- Department of Ophthalmology, Beizhen People's Hospital, Jinzhou, Liaoning, China
| | - Xiaochang Yan
- National School of Development, Peking University, Beijing, China
| | - Shaoye Bo
- Department of Supervisory Board, China Foundation for Disabled Persons, Beijing, China
| | - Xinghuai Sun
- Department of Ophthalmology and Vision Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Nai-Jun Tang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Key Laboratory of Environment, Nutrition, and Public Health, Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin, China
| | - Chun Zhang
- Department of Ophthalmology, Peking University Eye Center, Third Hospital of Peking University, Beijing, China
| | - Hua Yan
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
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Marta K, Katarzyna C, Marta K, Włodzimierz G, Maciej M, Bartłomiej K. How Does Weight Loss After Bariatric Surgery Impact the Ocular Parameters? A Review. Obes Surg 2023:10.1007/s11695-023-06607-1. [PMID: 37103665 DOI: 10.1007/s11695-023-06607-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 04/13/2023] [Accepted: 04/17/2023] [Indexed: 04/28/2023]
Abstract
Our review aimed to assess the effects of bariatric surgery-induced weight loss on ocular functions. We focused on retinochoroidal microcirculation, glaucomatous factors, and the condition of the eye surface pre- and postoperatively. The review covered 23 articles, including five case reports. Bariatric surgery positively impacts retinochoroidal microcirculation. The arterial perfusion and vascular density improve, venules constrict, and the arteriole-to-venule ratio increases. Weight loss positively correlates with intraocular pressure decrease. The impact of postoperative weight loss on the choroidal thickness (CT) and the retinal nerve fiber layer (RNFL) is still unclear. The correlation between ocular symptoms and hypovitaminosis A needs to be evaluated. Further research is required, especially regarding CT and RNFL, mainly focusing on long-term follow-up.
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Affiliation(s)
- Krzyżanowska Marta
- Division of Ophthalmology and Optometry, Department of Ophthalmology, Collegium Medicum, Nicolaus Copernicus University in Toruń, ul. Ujejskiego 75, 85-168, Bydgoszcz, Poland.
| | - Czarny Katarzyna
- Division of Ophthalmology and Optometry, Department of Ophthalmology, Collegium Medicum, Nicolaus Copernicus University in Toruń, ul. Ujejskiego 75, 85-168, Bydgoszcz, Poland
| | - Kroczek Marta
- Division of Ophthalmology and Optometry, Department of Ophthalmology, Collegium Medicum, Nicolaus Copernicus University in Toruń, ul. Ujejskiego 75, 85-168, Bydgoszcz, Poland
| | - Gniłka Włodzimierz
- Department of General and Minimally Invasive Surgery, Jan Biziel University Hospital Number 2, ul. Ujejskiego 75, 85-168, Bydgoszcz, Poland
| | - Michalik Maciej
- Department of General and Minimally Invasive Surgery, Jan Biziel University Hospital Number 2, ul. Ujejskiego 75, 85-168, Bydgoszcz, Poland
| | - Kałużny Bartłomiej
- Division of Ophthalmology and Optometry, Department of Ophthalmology, Collegium Medicum, Nicolaus Copernicus University in Toruń, ul. Ujejskiego 75, 85-168, Bydgoszcz, Poland
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Coster D, Rafie A, Savion-Gaiger N, Rachmiel R, Kurtz S, Berliner S, Shapira I, Zeltser D, Rogowski O, Shenhar-Tsarfaty S, Waisbourd M. The effect of body mass index reduction on intraocular pressure in a large prospective cohort of apparently healthy individuals in Israel. PLoS One 2023; 18:e0285759. [PMID: 37196013 DOI: 10.1371/journal.pone.0285759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/01/2023] [Indexed: 05/19/2023] Open
Abstract
PURPOSE To investigate the effect of change in body mass index (BMI) on intraocular pressure (IOP) in a large cohort of apparently healthy volunteers who underwent an annual comprehensive screening examinations. METHODS This study included individuals who were enrolled in the Tel Aviv Medical Center Inflammation Survey (TAMCIS) and had IOP and BMI measurements at their baseline and follow up visits. Relationships between BMI and IOP and the effect of change in BMI on IOP were investigated. RESULTS A total of 7,782 individuals had at least one IOP measurement at their baseline visit, and 2,985 individuals had ≥2 visits recorded. The mean (SD) IOP (right eye) was 14.6 (2.5) mm Hg and mean (SD) BMI was 26.4 (4.1) kg/m2. IOP positively correlated with BMI levels (r = 0.16, p<0.0001). For individuals with morbid obesity (BMI≥35 kg/m2) and ≥2 visits, a change in BMI between the baseline and first follow-up visits correlated positively with a change in the IOP (r = 0.23, p = 0.029). Subgroup analysis of subjects who had a reduction of at least 2 BMI units showed a stronger positive correlation between change in BMI and change in IOP (r = 0.29, p<0.0001). For this subgroup, a reduction of 2.86 kg/m2 of BMI was associated with a reduction of 1 mm Hg in IOP. CONCLUSIONS BMI loss correlated with reduction in IOP, and this correlation was more pronounced among morbidly obese individuals.
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Affiliation(s)
- Dan Coster
- Blavatnik School of Computer Science, Tel-Aviv University, Tel-Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Ariel Rafie
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Noam Savion-Gaiger
- Division of Ophthalmology, Tel Aviv Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Rony Rachmiel
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
- Division of Ophthalmology, Tel Aviv Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Shimon Kurtz
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
- Division of Ophthalmology, Tel Aviv Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Shlomo Berliner
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
- Division of Internal Medicine, Tel-Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Itzhak Shapira
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
- Division of Internal Medicine, Tel-Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - David Zeltser
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
- Division of Internal Medicine, Tel-Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Ori Rogowski
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
- Division of Internal Medicine, Tel-Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Shani Shenhar-Tsarfaty
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
- Division of Internal Medicine, Tel-Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Michael Waisbourd
- Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
- Division of Ophthalmology, Tel Aviv Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
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