Early Hyperbaric Oxygen Treatment for Nonarteritic Central Retinal Artery Obstruction

Menzel‐Severing, Johannes; Siekmann, Ullrich; Weinberger, A; Roessler, Gernot; Walter, Peter; Mazinani, Babac

doi:10.1016/j.ajo.2011.08.009

Cited by 58 publications

(35 citation statements)

References 21 publications

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“…Acuity improved in 83% of treated patients compared to 30% of controls, which had some adjunct treatments but no O 2 . Another successful trial was done with patients having 12 hours or less of occlusion (Menzel-Severing et al, 2012). These patients received 2.4 ATA for 3 times on the first day, for 90 min each, as well as hemodilution to reduce blood viscosity.…”

Section: Oxygen In Retinal Artery Occlusionmentioning

confidence: 99%

Retinal oxygen: from animals to humans

Linsenmeier

Zhang

2017

Progress in Retinal and Eye Research

192

150

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This article discusses retinal oxygenation and retinal metabolism by focusing on measurements made with two of the principal methods used to study O2 in the retina: measurements of PO2 with oxygen-sensitive microelectrodes in vivo in animals with a retinal circulation similar to that of humans, and oximetry, which can be used non-invasively in both animals and humans to measure O2 concentration in retinal vessels. Microelectrodes uniquely have high spatial resolution, allowing the mapping of PO2 in detail, and when combined with mathematical models of diffusion and consumption, they provide information about retinal metabolism. Mathematical models, grounded in experiments, can also be used to simulate situations that are not amenable to experimental study. New methods of oximetry, particularly photoacoustic ophthalmoscopy and visible light optical coherence tomography, provide depth-resolved methods that can separate signals from blood vessels and surrounding tissues, and can be combined with blood flow measures to determine metabolic rate. We discuss the effects on retinal oxygenation of illumination, hypoxia and hyperoxia, and describe retinal oxygenation in diabetes, retinal detachment, arterial occlusion, and macular degeneration. We explain how the metabolic measurements obtained from microelectrodes and imaging are different, and how they need to be brought together in the future. Finally, we argue for revisiting the clinical use of hyperoxia in ophthalmology, particularly in retinal arterial occlusions and retinal detachment, based on animal research and diffusion theory.

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Section: Oxygen In Retinal Artery Occlusionmentioning

confidence: 99%

Retinal oxygen: from animals to humans

Linsenmeier

Zhang

2017

Progress in Retinal and Eye Research

192

150

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“…44 Therapies to dilate the central retinal artery include sublingual isorbide nitrite 41 , rebreathing of expired carbon dioxide 45 , hyperbaric oxygen treatment 46 , and breathing a fixed mixture of 95% oxygen and 5% carbon dioxide (known as Carbogen) 47 . Ocular massage with direct digital pressure or three-mirror contact lens application has been reported to physically remove an embolus.…”

Section: Treatment and Management Of Acute Embolic Central Retinal Armentioning

confidence: 99%

Central Retinal Artery Occlusion: Acute Management and Treatment

Mehta

Marco

Goldhardt³

et al. 2017

Curr Ophthalmol Rep

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Purpose of Review This review will seek to answer if advances in ophthalmic imaging and evolution of treatment modalities have shed further light on the epidemiology, pathophysiology, diagnosis, and acute management of acute CRAO. Recent Findings Imaging characteristics of acute CRAO have been further characterized with the use of fluorescein angiography, optical coherence tomography (OCT), OCT-angiography, and indocyanine-green angiography. Layer segmentation of OCT imaging has found inner retinal layer hyper-reflectivity to be a common finding in acute CRAO. Non-invasive therapies, fibrinolytic delivery, and surgical interventions for acute CRAO have been further evaluated as potential management tools. Summary A large body of literature reports very inconsistent treatment success with a wide variety of modalities. Currently, there is no clear evidence supporting the use of fibrinolytics in acute CRAO. Large, multicenter, randomized control trials are necessary to elucidate the role of the various acute treatment options in the management of CRAO.

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“…13 Some authors describe that there are four important key factors to determine the HBOT success: time at HBOT is started, degree of vessel occlusion, the type of vessel that is occluded and the presence of an adequate PaO 2 of oxygen. The aetiology of the occlusion is also related as an important factor.…”

Section: Discussionmentioning

confidence: 99%

The efficacy of hyperbaric oxygen therapy in the treatment of central retinal artery occlusion

Soares¹,

Gomes

Mendonça

et al. 2017

BMJ Case Reports

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Central retinal artery occlusion (CRAO) is an ophthalmological emergency. Various treatment modalities have been tried, but none have shown to alter natural history of the disease. Hyperoxia can restore retinal oxygenation, and favourable results were obtained with hyperbaric oxygen therapy (HBOT). We report two patients with sudden visual loss due to CRAO treated with HBOT. Case 1: a 61-year-old female, presented with CRAO in her left eye(OS). She was submitted to eight sessions of HBOT(2.4atmosphere absolute (ATA)). BCVA(Best corrected visual acuity) improved from counting fingers (CF) to 1.0 and fluorescein angiography (FA) showed a normalisation. Vascular study showed a value of 8.8% for HbA1c and ventricular extrasystoles. Case 2: a 69-year-old male presented with CRAO in his OS. Nine sessions of HBOT(2.4 ATA) were performed. Best corrected visual acuity (BCVA)improved from CF to 0.8 and the FA was normalised. Vascular study revealed an atheromatous carotid disease, and cardiac pathology. HBOT seems to be beneficial on the recovery of vision following CRAO.

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Early Hyperbaric Oxygen Treatment for Nonarteritic Central Retinal Artery Obstruction

Cited by 58 publications

References 21 publications

Retinal oxygen: from animals to humans

Retinal oxygen: from animals to humans

Central Retinal Artery Occlusion: Acute Management and Treatment

The efficacy of hyperbaric oxygen therapy in the treatment of central retinal artery occlusion

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