Longitudinal Effect of Bariatric Surgery on Retinal Microcirculation and Target Organ Damage: the BASTOD Study

Eloi Debourdeau; Gabriel Gardes; David Nocca; Isabelle Carriere; Christophe Chiquet; Max Villain; Camille Roubille; Guilhem Du Cailar; Mathieu Sardinoux; Vincent Daien; Pierre Fesler

doi:10.1007/s11695-022-06064-2

Longitudinal Effect of Bariatric Surgery on Retinal Microcirculation and Target Organ Damage: the BASTOD Study

Obes Surg. 2022 Jul;32(7):1-10. doi: 10.1007/s11695-022-06064-2. Epub 2022 Apr 25.

Authors

Eloi Debourdeau^{1

2}, Gabriel Gardes³, David Nocca⁴, Isabelle Carriere⁵, Christophe Chiquet⁶, Max Villain³, Camille Roubille^{7

8}, Guilhem Du Cailar⁷, Mathieu Sardinoux⁷, Vincent Daien^{3

5

9}, Pierre Fesler^{7

8}

Affiliations

¹ Department of Ophthalmology, Gui de Chauliac Hospital, 80 Avenue Augustin Fliche, 34000, Montpellier, France. eloidebourdeau@gmail.com.
² Institute for Neurosciences of Montpellier INM, Univ. Montpellier, INSERM, 34091, Montpellier, France. eloidebourdeau@gmail.com.
³ Department of Ophthalmology, Gui de Chauliac Hospital, 80 Avenue Augustin Fliche, 34000, Montpellier, France.
⁴ Digestive Surgery Division A, CHU de Montpellier, F-34000, Montpellier, France.
⁵ Institute for Neurosciences of Montpellier INM, Univ. Montpellier, INSERM, 34091, Montpellier, France.
⁶ Department of Ophthalmology, Grenoble Alpes University Hospital, 38048, Grenoble, France.
⁷ Department of Internal Medicine, CHU Montpellier, Montpellier University, 34000, Montpellier, France.
⁸ PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214, 34000, Montpellier, France.
⁹ The Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, NSW, 2000, Australia.

PMID: 35469081
DOI: 10.1007/s11695-022-06064-2

Abstract

Purpose: Obesity is associated with increased cardiovascular risk. Bariatric surgery (BS) improves the clinical and metabolic profile. Retinal caliber changes could precede cardiovascular events. Different studies have shown an improvement in retinal caliber after BS. The aim of this study was to examine retinal caliber and other cardiovascular target organ damage before and after BS.

Materials and methods: Monocentric, prospective cohort study at the Montpellier University Hospital. Biologic features, vessel stiffness, echocardiograph variables, and retinal caliber at baseline and 6 and 12 months were assessed in consecutive patients with class 2 or 3 obesity undergoing BS. A mixed linear model adjusted for age and sex was used.

Results: We included 88 patients (75 women). The mean (SD) age was 43 years (11) and mean (SD) baseline weight 117 (21) Kg. Mean changes in the first year after BS were - 5.1 µm in central retinal vein equivalent (CRVE) (p < 0.0001), + 0.02 in arteriole-to-venule ratio (AVR) (p < 0.0001), - 1.4 mmol/L in glycemia (p < 0.0001), - 1.0 mg/L in natural logarithm of C-reactive protein (p < 0.0001), and - 54.0 g in left ventricular mass (p = 0.0005). We observed no significant improvement in arterial stiffness markers. Predictors of improvement in CRVE were high baseline weight (p = 0.030), male sex (p = 0.025), and no diabetes history (p Dynamic links between variations = 0.047).

Conclusion: The retinal microvascular phenotype improved during the first year after bariatric surgery, with decreased CRVE and increased AVR. Factors associated with retinal microvascular plasticity were male sex, high baseline weight, and absence of diabetes. Longitudinal assessment of retinal vascular calibers may offer new insights into the pathophysiology of subclinical vascular processes.

Keywords: Ankle Brachial Index; Bariatric surgery; Pulse wave analysis; Retinal vessels; Vascular stiffness; Weight loss.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Bariatric Surgery*
Female
Humans
Male
Microcirculation
Obesity
Obesity, Morbid* / surgery
Prospective Studies
Retinal Vessels / diagnostic imaging