title: Does bariatric surgery adversely impact on diabetic retinopathy in persons with morbid obesity and type 2 diabetes? A pilot study.
abstract: OBJECTIVE
  To assess the incidence and progression of diabetic retinopathy (DR) 12 months post bariatric surgery in persons with morbid obesity and type 2 diabetes.
  
  
  METHODS
  A retrospective pilot analysis of electronic hospital records between 1998 and 2012.
  
  
  RESULTS
  40 of 148 subjects had pre- and post-surgery DR screening. Of those without DR pre-surgery 1.5% (n = 26) progressed to minimum background DR (BDR) post surgery. Those with minimum BDR (n = 9) pre-surgery revealed no progression, with 55.6% (n = 5) showing evidence of regression. One person with moderately severe BDR and two with pre-proliferative DR (PPDR) prior to surgery experienced progression. Two persons with PPDR prior to surgery remained under the hospital eye services and were therefore not eligible to be re-assessed by the screening service.
  
  
  CONCLUSIONS
  There was a low incidence of new DR and progression of DR in those either without evidence of retinopathy or with minimal BDR prior to surgery with some subjects showing evidence of regression. There was however a risk of progression of DR in those with moderate BDR or worse, and should therefore be monitored closely post-surgery.
authors: Diabetes Research Group, Institute of Life Science, College of Medicine, Swansea University, Swansea, UK. Electronic address: r.l.thomas@swansea.ac.uk.
authors: Rebecca L
authors: RL
authors: Thomas
authors: Diabetes Research Group, Institute of Life Science, College of Medicine, Swansea University, Swansea, UK.
authors: Sarah L
authors: SL
authors: Prior
authors: Welsh Institute of Metabolic and Obesity Surgery, Morriston Hospital, Swansea, UK.
authors: Jonathan D
authors: JD
authors: Barry
authors: Diabetes Research Group, Institute of Life Science, College of Medicine, Swansea University, Swansea, UK.
authors: Stephen D
authors: SD
authors: Luzio
authors: Welsh Institute of Metabolic and Obesity Surgery, Morriston Hospital, Swansea, UK.
authors: Nia
authors: N
authors: Eyre
authors: Welsh Institute of Metabolic and Obesity Surgery, Morriston Hospital, Swansea, UK.
authors: Scott
authors: S
authors: Caplin
authors: Diabetes Research Group, Institute of Life Science, College of Medicine, Swansea University, Swansea, UK.
authors: Jeffrey W
authors: JW
authors: Stephens
authors: Diabetes Research Group, Institute of Life Science, College of Medicine, Swansea University, Swansea, UK.
authors: David R
authors: DR
authors: Owens
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050110:Bariatric Surgery / Q000009:adverse effects* / Q000706:statistics & numerical data; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology / Q000601:surgery*; D003930:Diabetic Retinopathy / Q000453:epidemiology / Q000209:etiology*; D018450:Disease Progression; D006801:Humans; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications* / Q000453:epidemiology / Q000601:surgery*; D010865:Pilot Projects; D012189:Retrospective Studies; D006113:United Kingdom / Q000453:epidemiology; D014852:Wales / Q000453:epidemiology; D055815:Young Adult
keywords: Bariatric surgery; Diabetic Retinopathy; Obesity; Type 2 diabetes