Abstract:
Importance:Knowledge of the incidence and progression of diabetic retinopathy (DR) after gastric bypass surgery (GBP) in patients with obesity and diabetes could guide the management of these patients. Objective:To investigate the incidence of diabetic ocular complications in patients with type 2 diabetes after GBP compared with the incidence of diabetic ocular complications in a matched cohort of patients with obesity and diabetes who have not undergone GBP. Design, Setting, and Participants:Data from 2 nationwide registers in Sweden, the Scandinavian Obesity Surgery Registry and the National Diabetes Register, were used for this cohort study. A total of 5321 patients with diabetes from the Scandinavian Obesity Surgery Registry who had undergone GBP from January 1, 2007, to December 31, 2013, were matched with 5321 patients with diabetes from the National Diabetes Register who had not undergone GBP, based on sex, age, body mass index (BMI), and calendar time (2007-2013). Follow-up data were obtained until December 31, 2015. Statistical analysis was performed from October 5, 2018, to September 30, 2019. Exposure:Gastric bypass surgery. Main Outcomes and Measures:Incidence of new DR and other diabetic ocular complications. Results:The study population consisted of 5321 patients who had undergone GBP (3223 women [60.6%]; mean [SD] age, 49.0 [9.5] years) and 5321 matched controls (3395 women [63.8%]; mean [SD] age, 47.1 [11.5] years). Mean (SD) follow-up was 4.5 (1.6) years. The mean (SD) BMI and hemoglobin A1c concentration at baseline were 42.0 (5.7) and 7.6% (1.5%), respectively, in the GBP group and 40.9 (7.3) and 7.5% (1.5%), respectively, in the control group. The mean (SD) duration of diabetes was 6.8 (6.3) years in the GBP group and 6.4 (6.4) years in the control group. The risk for new DR was reduced in the patients who underwent GBP (hazard ratio, 0.62 [95% CI, 0.49-0.78]; P < .001). The dominant risk factors for development of DR at baseline were diabetes duration, hemoglobin A1c concentration, use of insulin, glomerular filtration rate, and BMI. Conclusions and Relevance:This nationwide matched cohort study suggests that there is a reduced risk of developing new DR associated with GBP, and no evidence of an increased risk of developing DR that threatened sight or required treatment.
journal_name
JAMA Ophthalmoljournal_title
JAMA ophthalmologyauthors
Åkerblom H,Franzén S,Zhou C,Morén Å,Ottosson J,Sundbom M,Eliasson B,Svensson AM,Granstam Edoi
10.1001/jamaophthalmol.2020.5892subject
Has Abstractpub_date
2021-01-14 00:00:00eissn
2168-6165issn
2168-6173pii
2774807pub_type
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journal_title:JAMA ophthalmology
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pub_type: 杂志文章,随机对照试验
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abstract:Importance:Mutations in the myocilin (MYOC) gene are the most common molecularly defined cause of primary open-angle glaucoma that typically occurs in patients with high intraocular pressures (IOP). One MYOC mutation, p.Gln368Ter, has been associated with as many as 1.6% of primary open-angle glaucoma cases that had a ...
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更新日期:2016-04-01 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2016-08-01 00:00:00
abstract:Importance:The Diabetic Retinopathy Clinical Research Network Protocol S randomized clinical trial results suggest that ranibizumab is a reasonable treatment alternative to panretinal photocoagulation (PRP) when managing proliferative diabetic retinopathy (PDR), with or without concomitant baseline diabetic macular ede...
journal_title:JAMA ophthalmology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1001/jamaophthalmol.2017.0837
更新日期:2017-06-01 00:00:00
abstract:OBJECTIVE:To investigate the efficacy of WINROP (https://winrop.com), an algorithm based on serial measurements of neonatal body weight to predict proliferative retinopathy of prematurity (ROP), in a Korean population of preterm infants. METHODS:The records of preterm infants with gestational age less than 32 weeks wh...
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更新日期:2013-01-01 00:00:00
abstract:Importance:There are limited published data on the phenotype of retinitis pigmentosa (RP) related to CNGB1 variants. These data are needed both for prognostic counseling of patients and for understanding potential treatment windows. Objective:To describe the detailed clinical and molecular genetic findings in a series...
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更新日期:2017-02-01 00:00:00
abstract:IMPORTANCE:Medication persistence is an important factor for treatment effect in patients with glaucoma. Evaluating risk factors for refill discontinuation might be helpful for improving persistence and preventing blindness in patients with glaucoma. OBJECTIVES:To estimate the persistence rate with topical glaucoma me...
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更新日期:2014-12-01 00:00:00
abstract:Objective:To compare oral voriconazole with placebo in addition to topical antifungals in the treatment of filamentous fungal keratitis. Design, Setting, and Participants:The Mycotic Ulcer Treatment Trial II (MUTT II), a multicenter, double-masked, placebo-controlled, randomized clinical trial, was conducted in India ...
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更新日期:2013-11-01 00:00:00
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更新日期:2020-04-01 00:00:00
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更新日期:2019-08-29 00:00:00
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journal_title:JAMA ophthalmology
pub_type: 杂志文章,多中心研究
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更新日期:2017-06-01 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2016-02-01 00:00:00
abstract:Importance:The 2-year efficacy and safety of combination therapy of ranibizumab administered together with verteporfin photodynamic therapy (vPDT) compared with ranibizumab monotherapy in participants with polypoidal choroidal vasculopathy (PCV) are unclear. Objective:To compare treatment outcomes of ranibizumab, 0.5 ...
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更新日期:2020-09-01 00:00:00
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pub_type: 杂志文章
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更新日期:2020-10-01 00:00:00
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更新日期:2018-09-01 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2016-08-01 00:00:00