Nutritional Optic Neuropathy Status Post Bariatric Surgery

Chacko, Joseph G.; Rodriguez, Christopher J.; Uwaydat, Sami H.

doi:10.3109/01658107.2012.700993

Cited by 7 publications

(9 citation statements)

References 8 publications

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“…This was shown by Chacko et al . [ 11 ], who published a case of a female patient with the symptoms of NON associated with folic acid and vitamin B complex deficiency, diagnosed 3 years after a bariatric procedure. The symptoms did not resolve despite implementation of appropriate supplementation, which was probably a consequence of too late diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…However, little is known about the effects of bariatric procedures on the function of the optic nerve. Sparse literature data point to potential risk of NON in patients subjected to bariatric procedures [ 11 , 12 ]. Nutritional neuropathies develop slowly and “insidiously”, and can lead to permanent loss of vision when diagnosed too late and/or left untreated.…”

Section: Introductionmentioning

confidence: 99%

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Nutritional optic neuropathy following bariatric surgery.

Sawicka-Pierko¹,

Obuchowska²,

Hady³

et al. 2014

Videosurgery and Other Miniinvasive Techniques

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Bariatric procedures, associated with gastrointestinal malabsorption of vitamins and microelements, may constitute a risk factor for nutritional optic neuropathy (NON). We present a case of a 34-year-old female patient who developed bilateral NON after sleeve gastrectomy. Despite postoperative ophthalmological supervision, 10 months after the procedure the woman presented with a bilateral decrease in visual acuity down to 0.8, bilateral visual field loss and abnormal visual evoked potential recordings. Laboratory abnormalities included decreased serum concentration of vitamin B12 (161 pg/ml). Treatment was based on intramuscular injections of vitamin B12 (1000 units per day). After 1 week of the treatment, we observed more than a three-fold increase in the serum concentration of vitamin B12 and resolution of the bilateral symptoms of NON. The incidence of NON is likely to increase due to the growing number of these bariatric procedures performed worldwide. Therefore, all persons subjected to such surgery should receive long-term ophthalmological follow-up and supplementation with vitamins and microelements.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Nutritional optic neuropathy following bariatric surgery.

Sawicka-Pierko¹,

Obuchowska²,

Hady³

et al. 2014

Videosurgery and Other Miniinvasive Techniques

View full text Add to dashboard Cite

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“…In toxic/nutritional optic neuropathies, the OCT-measured RNFL shows preferential thinning temporally, which corresponds to the significant effects on the papillomacular fibres. 16,17 In addition, blood work revealed no evidence of macrocytic anaemia, which would be expected if vitamin B 12 or folate were deficient.…”

Section: Discussionmentioning

confidence: 89%

Optic Atrophy in End-Stage Giant Axonal Neuropathy: A Case Report

Wubben

Eghrari

McCoy

et al. 2013

Neuro-Ophthalmology

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A 32-year-old woman with a history of biopsy-proven giant axonal neuropathy (GAN) and no past ocular history presented after failing a vision-screening test conducted by her primary doctor. Bilateral optic atrophy was observed on fundus examination with cup-to-disc ratio of 0.7. Kinetic visual fields showed moderate constriction in both eyes. Optical coherence tomography (OCT) of the retinal nerve fibre layer (RNFL) exhibited diffuse thinning, a pattern atypical of glaucomatous or nutritional optic atrophy and most likely secondary to the optic atrophy associated with GAN. Serial OCT to monitor RNFL thickness may offer a non-invasive means of monitoring progression in GAN for future therapeutic studies.

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“…However, despite these benefits, without adequate follow-up bariatric surgery has long-term risks including significant nutritional deficiencies and weight regain, and for some, the consequences can be significant (8)(9)(10). For example, there are case reports of nutritional deficiencies leading to night-blindness, cardiomyopathy and neuropathy, including permanent disability or death in some cases (11)(12)(13)(14)(15). These case reports commonly cite inadequate follow-up or adherence to supplements as a contributing factor.…”

Section: Introductionmentioning

confidence: 99%

“… 8 – 10 For example, there have been case reports of nutritional deficiencies leading to night-blindness, cardiomyopathy, and neuropathy, including permanent disability or death in some cases. 11 – 15 These case reports commonly cite inadequate follow-up or adherence to supplements as a contributing factor. There is also evidence from cohort studies and systematic reviews that poor follow-up care and adherence to supplements have negative impacts on outcomes.…”

Section: Introductionmentioning

confidence: 99%

Post-bariatric surgery nutritional follow-up in primary care: a population-based cohort study

et al. 2020

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Background: Bariatric surgery is the most effective treatment for severe obesity. However, without recommended follow-up it has long-term risks. Aim: To investigate whether nutritional and weight monitoring in primary care meets current clinical guidance, post-specialist discharge. Design and setting: Retrospective cohort study. Primary care practices contributing to IQVIA Medical Research Data (IMRD)–UK (1/1/2000-17/1/2018). Methods: Participants were adults who had had bariatric surgery with a minimum of three years’ follow-up post-surgery as this study focused on patients discharged from specialist care (at 2yrs post-surgery). Outcomes were annual proportion of patients from 2yrs post-surgery with a record of recommended nutritional screening blood tests, weight measurement and prescription of nutritional supplements, and proportions with nutritional deficiencies based on blood tests. Results: 3137 participants were included and median follow-up post-surgery was 5.7 (4.2-7.6) years. 45-59% had an annual weight measurement. The greatest proportions of patients with a record of annual nutritional blood tests were for tests routinely conducted in primary care, e.g. recorded haemoglobin measurement varied between 44.9% (n=629/1400) and 61.2% (n=653/1067). Annual proportions of blood tests specific to bariatric surgery were low, e.g. recorded copper measurement varied between 1.2% (n=10/818) and 1.5% (n=16/1067) (where recommended). Results indicated that the most common deficiency was anemia. Annual proportions of patients with prescriptions for recommended nutritional supplements were low. Conclusions: Our study suggests that bariatric surgery patients are not receiving recommended nutritional monitoring post-specialist discharge. GPs and patients should be supported to engage with follow-up care. Future research should aim to understand reasons underpinning our findings.

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Nutritional Optic Neuropathy Status Post Bariatric Surgery

Cited by 7 publications

References 8 publications

Nutritional optic neuropathy following bariatric surgery.

Nutritional optic neuropathy following bariatric surgery.

Optic Atrophy in End-Stage Giant Axonal Neuropathy: A Case Report

Post-bariatric surgery nutritional follow-up in primary care: a population-based cohort study

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