Our Summary

This research paper is about a study conducted to see if obese patients undergoing weight loss surgery need to be screened for a condition called idiopathic intracranial hypertension (IIH). IIH is a serious condition often associated with vision loss and is more common in obese women. The researchers used a method called the peripapillary retinal nerve fiber layer (RNFL) thickness to look for signs of IIH in the patients.

The study included 36 obese patients scheduled for weight loss surgery and 20 non-obese people for comparison. The researchers measured the thickness of the RNFL in all the participants.

The results showed that none of the patients had signs of IIH. However, the RNFL was thinner in obese individuals compared to the non-obese group. This was the case even after considering other factors like high blood pressure, high cholesterol, diabetes, age, sleep apnea, and sex.

The researchers concluded that there is no need to routinely screen obese patients for IIH before weight loss surgery based on the RNFL thickness. However, they found that severe obesity is associated with neurodegeneration (damage to the brain and nervous system) regardless of other health conditions, which might justify future investigation on the need to monitor these patients.

FAQs

  1. What is the purpose of the research study conducted on obese patients undergoing weight loss surgery?
  2. What is idiopathic intracranial hypertension (IIH) and how is it related to obesity?
  3. Did the researchers find a need to routinely screen obese patients for IIH before weight loss surgery based on the RNFL thickness?

Doctor’s Tip

A doctor might tell a patient undergoing retinal surgery to follow post-operative care instructions carefully, including avoiding strenuous activities, taking prescribed medications, attending follow-up appointments, and reporting any changes in vision or eye discomfort immediately. It is important to protect the eyes from injury and infection during the healing process to ensure the best possible outcome.

Suitable For

Patients who are typically recommended for retinal surgery include those with conditions such as:

  1. Retinal detachment: This occurs when the retina separates from the back of the eye, leading to vision loss.

  2. Macular hole: This is a small break in the macula, the central part of the retina responsible for sharp central vision.

  3. Epiretinal membrane: This is a thin layer of scar tissue that forms on the surface of the retina, affecting vision.

  4. Diabetic retinopathy: This is a complication of diabetes that affects the blood vessels in the retina, leading to vision loss.

  5. Age-related macular degeneration: This is a common eye condition in older adults that causes loss of central vision.

  6. Retinal vein occlusion: This occurs when a vein in the retina becomes blocked, leading to vision loss.

  7. Retinal artery occlusion: This occurs when an artery in the retina becomes blocked, leading to vision loss.

  8. Retinitis pigmentosa: This is a group of genetic disorders that affect the retina, leading to vision loss.

Overall, patients with retinal conditions that can potentially lead to vision loss or other serious complications are typically recommended for retinal surgery.

Timeline

Before retinal surgery:

  1. Patient is diagnosed with a retinal condition or injury that requires surgery.
  2. Patient undergoes pre-operative testing and evaluations to assess their overall health and suitability for surgery.
  3. Patient may need to stop certain medications or make lifestyle changes in preparation for surgery.
  4. Patient meets with the surgeon to discuss the procedure, risks, and expected outcomes.
  5. Surgery date is scheduled and patient receives instructions on how to prepare for the procedure.

After retinal surgery:

  1. Patient undergoes the surgical procedure to repair the retinal condition or injury.
  2. Patient is monitored closely in the immediate post-operative period for any complications or signs of infection.
  3. Patient may experience discomfort, blurry vision, or sensitivity to light in the days following surgery.
  4. Patient may need to use eye drops or take medications as prescribed by the surgeon to aid in healing and prevent infection.
  5. Patient attends follow-up appointments with the surgeon to assess the success of the surgery and monitor the healing process.
  6. Patient may need to undergo additional treatments or procedures to optimize their vision and overall eye health.

What to Ask Your Doctor

  1. What is idiopathic intracranial hypertension (IIH) and how does it affect the eyes?

  2. How is the peripapillary retinal nerve fiber layer (RNFL) thickness measured and what does it indicate?

  3. What are the risk factors for developing IIH, and how common is it in obese individuals?

  4. What are the potential consequences of untreated IIH, particularly in obese patients?

  5. Are there any symptoms or warning signs of IIH that patients should be aware of?

  6. Are there any other tests or screenings that should be done to assess the risk of IIH in obese patients undergoing weight loss surgery?

  7. What are the implications of the study’s findings that the RNFL thickness was thinner in obese individuals compared to non-obese individuals?

  8. How does severe obesity contribute to neurodegeneration, and what are the potential implications for future monitoring of obese patients?

  9. What are the potential long-term effects on vision and overall health for obese patients who do not undergo screening for IIH before weight loss surgery?

  10. Are there any specific recommendations or guidelines for obese patients undergoing weight loss surgery in terms of monitoring for IIH or other related conditions?

Reference

Authors: Laiginhas R, Guimarães M, Cardoso P, Santos-Sousa H, Preto J, Nora M, Chibante J, Falcão-Reis F, Falcão M. Journal: Obes Surg. 2019 Jul;29(7):2174-2179. doi: 10.1007/s11695-019-03806-7. PMID: 30864103