Hyperbaric Oxygen Therapy in Retinal Arterial Occlusion: Epidemiology, Clinical Approach, and Visual Outcomes

Abstract

properly cited.Purpose. To evaluate the e cacy and safety of hyperbaric oxygen therapy (HBOT) in patients with acute retinal artery occlusion (RAO). Secondarily, to analyse the epidemiology and the clinical approach. Methods. Retrospective study of 13 patients submitted to HBOT between 2013 and 2018. e analysed parameters consisted of: systemic history, time between symptoms onset and treatment, initial approach, number of HBOT sessions, complications of HBOT and best corrected visual acuity-BCVA (of the total sample, central RAO-CRAO-group, and branch RAO-BRAO group). Results. Arterial hypertension was the most prevalent systemic risk factor (53.8%). Initial therapies were 100% normobaric oxygen administration, topical and oral hypotensive medication, eye massage and aspirin. CRAO was observed in 69.2% and BRAO in 30.8% of the cases, with clinically signi cant visual improvement (a decrease in logMAR of 0.3) in 55.5% and 75%, respectively. Time between symptoms onset and treatment had a median of 9 hours. e median number of HBOT sessions was 7, without complications. Conclusions. HBOT provide BCVA improvement in patients with RAO, when it is performed in an early time a er the symptom onset. It seems to be an e ective and safe therapeutic option for a pathology that still remains without approved treatment.

Conservative treatments for acute nonarteritic central retinal artery occlusion

“…There are only a few studies that report visual improvement, and most are case reports or small series without a control group [ Table 1 ]. [ 29 30 31 32 33 34 35 36 37 38 39 ]…”

The Effects of Hyperbaric Oxygen Therapy in Patients with Central Retinal Artery Occlusion: A Retrospective Study, Systematic Review, and Meta-analysis

“…Referring to the studies in rhesus monkeys [ 12 ], given the dramatic change of visual fate over a matter of few minutes time elapse, it appears that the source of bias and controversy among reported studies might stem from the timing of treatment. For instance, in comparison to our retrospective analysis with average time elapse of 18 hours from symptom onset to oxygen therapy, other studies that show improved VA from HBOT initiated treatment within 6 to 12 hours of visual loss [ 9 , 14 , 15 ]. Therefore, it is still possible that there might be beneficial effects from very early administration of HBOT.…”

Expert recommendations on the assessment and management of complications due to hyaluronic acid soft tissue filler injections in Asians

“…A regimen comprising 0.5% timolol eye drops every 12 hours and acetazolamide 250 mg 1 tab every 6 hours may be considered 5 . Reduction of intraocular pressure by ocular massage or anterior chamber paracentesis, and hyperbaric oxygen remains the gold standard treatment for central retinal artery occlusion 53 . Although intraarterial thrombolysis therapy might provide some benefits to patients suffering from visual compromise induced by hyaluronic acid embolism, 49,54 the experts found its role controversial and it was at most time difficult to provide the procedure in the optimal time window.…”