ABSTRACT
PURPOSE: To evaluate the effect of weight loss on the retrobulbar hemodynamics in patients who had undergone bariatric surgery for obesity using color Doppler ultrasound (CDU) and to evaluate correlations with intraocular pressure (IOP) changes measured using Goldman applanation tonometry. METHODS: Thirty-two patients were included in this prospective study. Body mass index (BMI), IOP measurements, and retrobulbar CDU examination were performed on all individuals 6 months before and after bariatric surgery. RESULTS: The preoperative mean BMI value was 48.8 ± 2.27 kg/m2, and mean IOP value was 18.2 ± 2.06 mmHg. At 6 months postoperatively, mean BMI and IOP were 36.28 ± 5.41 kg/m2 and 16.1 ± 1.81 mmHg which was statistically significantly lower than the preoperative measurements (p < 0.001). In the comparison of pre- and postoperative orbital CDU value, the preoperative OA PSV (30.16 ± 5.31 cm/s) and OA EDV (10.93 ± 3.04) values were significantly lower than the postoperative OA PSV (36.21 ± 5.56) and OA EDV (12.84 ± 3.38) values (p < 0.001 and p < 0.05, respectively). A significant correlation was determined between BMI and IOP (r = -0.443; p < 0.05). CONCLUSIONS: Decrease in body weight resulting from bariatric surgery performed on morbid obese patients causes alterations in both IOP and retrobulbar hemodynamics. Morbidly obese patients who undergo bariatric surgery have statistically significantly lower IOP values and increase in OA Doppler parameters (PSV, EDV) than in the preoperative period, which reflects a better retrobulbar and ocular blood flow.
Subject(s)
Bariatric Surgery , Ciliary Arteries/physiopathology , Obesity, Morbid/surgery , Ophthalmic Artery/physiopathology , Regional Blood Flow/physiology , Retinal Artery/physiopathology , Ultrasonography, Doppler, Color/methods , Adult , Blood Flow Velocity/physiology , Body Mass Index , Ciliary Arteries/diagnostic imaging , Eye/blood supply , Female , Follow-Up Studies , Humans , Male , Ophthalmic Artery/diagnostic imaging , Orbit/blood supply , Prospective Studies , Retinal Artery/diagnostic imagingABSTRACT
ABSTRACT Purpose: To evaluate intraocular pressure (IOP) and extraocular orbital vessels with color Doppler ultrasound (CDU) and investigate the effects of obesity on retrobulbar blood flow. Methods: Fifty-nine patients were included in this prospective study. Patients were divided into two groups according to body mass index: Group 1 (31 obese patients) and Group 2 (28 non-obese patients). IOP was measured with a Goldmann applanation tonometer, and CDU was used to evaluate the retrobulbar vessels. Results: The mean IOP was 18 ± 6.68 mmHg in the obese group and 13.71 ± 1.60 mmHg in the control group (p<0.001). When the CDU values for the central retinal artery were compared between the groups, the pulsatility index was found to be significantly lower in the obese group than in the control group (p<0.001). When the CDU values for the ophthalmic artery (OA) were compared between the groups, the peak systolic velocity (p<0.001) and end-diastolic velocity (p=0.002) values were found to be significantly lower in the obese group than in the control group. Conclusions: Obese patients have a higher mean IOP and lower flow velocity than non-obese patients. Increased IOP together with decreased retrobulbar blood flow, particularly in obese individuals, may increase the risk of glaucoma development.
RESUMO Objetivo: Avaliar a pressão intraocular (PIO) e vasos orbitários extraoculares com ultrassom Doppler colorido (UDC) e investigar os efeitos da obesidade sobre o fluxo sanguíneo retrobulbar. Métodos: Cinquenta e nove pacientes foram incluídos neste estudo prospectivo. Os pacientes foram divididos em dois grupos de acordo com o índice de massa corpo ral (IMC): Grupo 1 (31 pacientes obesos) e Grupo 2 (28 não obesos). As pressões intraoculares (PIOs) foram medidas com tonômetro de aplanação de Goldmann e o UDC foi utilizada para a avaliação de vasos retrobulbar. Resultados: As PIOs foram 18 ± 6,68 mmHg nos pacientes obesos e 13,71 ± 1,60 mmHg nos grupos controle (p<00,001). Quando os valores da artéria central da retina (ACR) foram comparados entre os grupos controle e obeso. O índice pulsátil (PI) foi marcadamente menor no grupo obeso (p<00,001). Quando os valores da artéria oftálmica (AO) dos grupos obesos e de controle foram comparados. Os valores de Velocidade do pico sistólico (PSV) (p<00,001) e velocidade diastólica final (EDV) (p=00,002) foram significativamente mais baixos no grupo obeso. Conclusão: Pacientes obesos têm maior PIO do que os pacientes não obesos. Os pacientes obesos têm diminuição nas velocidades de fluxo da AO. O aumento da PIO. Juntamente com a diminuição do fluxo sanguíneo retrobulbar, especialmente em indivíduos obesos, pode aumentar o risco de desenvolvimento de glaucoma.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Ophthalmic Artery/physiopathology , Regional Blood Flow/physiology , Retinal Artery/physiopathology , Intraocular Pressure/physiology , Obesity/physiopathology , Ophthalmic Artery/diagnostic imaging , Reference Values , Retinal Artery/diagnostic imaging , Tonometry, Ocular , Body Mass Index , Case-Control Studies , Sex Factors , Glaucoma/etiology , Prospective Studies , Risk Factors , Age Factors , Ultrasonography, Doppler, Color , Statistics, Nonparametric , Eye/blood supply , Hemodynamics/physiologyABSTRACT
ABSTRACT Purpose: To evaluate the thicknesses of the peripapillary retinal nerve fiber layer (RNFL), ganglion cell complex (GCL), and choroid layer using spectral domain optical coherence tomography (SD-OCT) for investigating the effects of vascular changes on the eye and optic nerve in patients who have migraine with aura. Methods: Forty-five patients who had migraine with aura (migraine group) and 45 healthy individuals (control group) were enrolled in the study. Age, gender, duration after migraine diagnosis, intraocular pressure, and axial length measurements were recorded in each case. RNFL, GCL, and choroid layer thicknesses were measured using SD-OCT in all participants. Results: The mean age was 36.1 ± 6.7 (20-45) years in the migraine group and 35.7 ± 8.6 (19-45) years in the control group. There was no significant difference in the RNFL thicknesses of the temporal and nasal quadrants (p >0.05). The RNFL thicknesses of the superior and inferior quadrants were significantly lower in the migraine group compared with those in the control group (p =0.001, p <0.01, respectively). Measurements for the superior and inferior GCL were not significantly different between the groups (p >0.05). Subfoveal, temporal, and nasal choroidal thickness measurements at 500 µm, 1000 µm, and 1500 µm were significantly lower in the migraine group than in the control group (p =0.001; p <0.01, respectively). Conclusions: Compared with the controls, the RNFL and choroid layer were determined to be thinner in patients who had chronic migraine with aura.
RESUMO Objetivo: Avaliar as espessuras de camada peripapilar de fibras nervosas retinianas (RNFL), complexo de células ganglionares (GCL) e da coroide utilizando a tomografia de coerência óptica de domínio espectral (SD-OCT), a fim de investigar os efeitos das alterações vasculares no olho e nervo óptico em pacientes que apresentam enxaqueca com aura. Métodos: Quarenta e cinco pacientes que apresentavam enxaqueca com aura (grupo enxaqueca) e 45 indivíduos saudáveis (grupo controle) foram incluídos no estudo. Idade, sexo, duração da enxaqueca, pressão intraocular e medidas de comprimento axial foram registrados em cada caso. Medidas da RNFL, GCL e espessuras da coroide foram obtidas com SD-OCT em todos os participantes. Resultados: A média da idade foi de 36,1 ± 6,7 (20-45) anos no grupo enxaqueca e 35,7 ± 8,6 (19-45) anos no grupo controle. Não houve diferença significativa em espessuras RNFL nos quadrantes temporal e nasal (p>0,05). A espessura da RNFL nos quadrantes superiores e inferiores foram significativamente menores no grupo de enxaqueca em comparação ao grupo controle (p=0,001; p<0,01). Medidas da GCL superior e inferior não mostraram diferença significativa entre os grupos (p>0,05). Espessuras subfoveais, temporais e nasais da coroide (CT) a 500 µm, 1000 µm e 1500 µm foram significativamente menores no grupo de enxaqueca em relação ao grupo controle (p=0,001; p<0,01). Conclusões: Comparados aos controles, as espessuras da RNFL e coroide foram mais finas em pacientes que apresentavam enxaqueca crônica com aura.
