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목적 : To clarify the impact of bariatric surgery on diabetic retinopathy (DR)
방법 : A comprehensive search was performed in the data bases of PubMED, EMBASE, Web of Science, and the Cochrane Library from inception to February 2016. Eligible studies were retrospective or prospective studies reporting changes in DR severity as primary or secondary outcomes after bariatric surgery. A random-effects model was used to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs) for progression of DR
결과 : 13 studies, 899 patients who underwent bariatric surgery were selected. The pooled ORs showed less DR progression in patients with bariatric surgery than with medical treatment alone (OR,0.47;95%CI,0.22~0.99). The postoperative progression odds were not different between the patients with DR and without DR (OR,1.04;95%CI,0.35~3.11). Another meta-analysis to investigate the effects of surgery depending on preexisting sight-threatening DR showed no difference (OR,1.88;95%CI,0.29~12.25) with borderline heterogeneity (I2=48%). Remission of diabetes could not prevent the progression after surgery
결론 : Bariatric surgery is associated with less progression of DR compared to medical treatment alone, particularly in early stages of disease. The progression odds were not significantly different between patients with DR and those with no DR preoperatively
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