Central Retinal Vein Occlusion after Gastric Bypass Surgery
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LETTER TO THE EDITOR
Central Retinal Vein Occlusion after Gastric Bypass Surgery Rita Laiginhas 1 & João Esteves-Leandro 2 & Pedro Cardoso 2 & Hugo Santos-Sousa 3,4 & John Preto 3,4 & Fernando Falcão-Reis 2,5 & Manuel Falcão 2,5
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Introduction Central retinal vein occlusion (CRVO) is a common and sightthreatening microvascular disorder that is known to occur as a result of a combination of factors that constitute the Virchow’s triad, including vascular wall damage, stasis, and hypercoagulability [1]. Common risk factors include age and hypertension; however, other associations have been reported including diabetes, dyslipidemia, systemic vascular disorders, and hypercoagulable states [1]. CRVO typically leads to painless vision loss but severity ranges along a continuum from asymptomatic to severe according to the level of ischemia and macular edema that occur [2]. Obesity is a disease defined as a body mass index above 30 kg/m2. Affected individuals are predisposed to the development of several co-morbidities, including hypertension, diabetes, and dyslipidemia, that together are responsible for long-term cardiovascular morbidity [3]. Obesity is a key risk factor for chronic renal disease through direct adverse effects on the kidney and indirectly through its association with intermediate disease states like diabetes and hypertension [4]. Bariatric surgery is growing worldwide as a treatment for obesity as it provides a definitive treatment for both obesity
* Manuel Falcão [email protected] 1
Department of Ophthalmology, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, Portugal
2
Department of Ophthalmology, Centro Hospitalar de São João, Porto, Portugal
3
Department of Surgery, Centro Hospitalar e Universitário São João, Porto, Portugal
4
Department of Surgery, Faculty of Medicine of Porto University (FMUP), Porto, Portugal
5
Department of Surgery and Physiology, Faculty of Medicine of Porto University (FMUP), Porto, Portugal
and its co-morbidities [5]. Its success in quickly reverting even the most challenging cases of obesity as well as associated complications (including diabetes, hypertension, and dyslipidemia) have been making this procedure a first choice improving the long-term morbidity of these patients [6]. We report a rare case of an asymptomatic central CRVO occurring as a complication of a bariatric surgery.
Methods Case-report.
Results We report a case from a 60-year-old severely obese female patient (body mass index 38.4 Kg/m2) that was submitted to bariatric surgery for weight loss. She had a past medical history of long-term morbid obesity (maximum body mass index of 47.4 Kg/m2) previously managed with a gastric band that had to be removed because of slippage. During the 9 years after the band removal, she partly recovered the lost weight, and she was advised to be submitted to a gastric bypass for a definitive solution. Besides obesity, the patient had a concurrent medical history of type 2 diabetes
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