Late Hyperbaric Oxygen Treatment of Cilioretinal Artery Occlusion With Nonischemic Central Retinal Vein Occlusion Secondary to High Altitude

Gökçe, Gökçen; Metin, Süleyman; Erdem, Üzeyir; Sobacı, Güngör; Durukan, Ali Hakan; Çağatay, Halil Hüseyin; Ekinci, Metin

doi:10.1089/ham.2013.1086

Cited by 9 publications

(7 citation statements)

References 12 publications

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“…Intravenous fibrinolytic therapy may also induce serious haemorrhagic events, and the time of symptom onset is critical to be safe and effective [ 17 ]. In terms of oxygen therapy, the outcome remains inconsistent [ 18 – 20 ]. Because there are few randomized controlled trials (RCTs) and many case reports in the literature, there has been no meta-analysis on oxygen therapy in RAO patients.…”

Section: Introductionmentioning

confidence: 99%

Oxygen therapy in patients with retinal artery occlusion: A meta-analysis

Xiao-dong

Chen

et al. 2018

PLoS ONE

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BackgroundOxygen therapy has been widely used for RAO (retinal artery occlusion) patients; however, inconsistent results have been reported.MethodsPubMed, Web of Science, EMBASE, Medline (OvidSP), Cochrane, China National Knowledge Infrastructure (CNKI), and Wanfang Database were examined. The primary endpoint was visual acuity (VA), and RevMan software 5.3 was used to statistically analyze the outcomes.ResultsSeven randomized controlled trials (RCTs) met the inclusion criteria. Patients who received oxygen therapy exhibited probability of visual improvement about 5.61 times compared with the control group who did not receive oxygen therapy (OR = 5.61; 95% CI, 3.60–8.73; p < 0.01). No statistically significant difference was observed between oxygen inhalation methods (Chi2 = 0.18, df = 1, p = 0.67), combined therapy (Chi2 = 0.21, df = 1, p = 0.64), or RAO type (Chi2 = 0.06, df = 1, p = 0.81). Conversely, 100% oxygen (Chi2 = 4.55, df = 1, p < 0.05) and hyperbaric oxygen (Chi2 = 4.55, df = 1, p < 0.05) significantly improved VA in RAO patients. Better effect was showed in period within 3 months (Chi2 = 5.76, df = 1, p < 0.05). The most effective treatment length was over 9 hours (Chi2 = 6.58, df = 1, p < 0.05).ConclusionOxygen therapy demonstrated beneficial effects in improving VA in RAO patients, particularly when patients were treated with 100% hyperbaric oxygen and for over 9 hours.

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Section: Introductionmentioning

confidence: 99%

Oxygen therapy in patients with retinal artery occlusion: A meta-analysis

Xiao-dong

Chen

et al. 2018

PLoS ONE

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“…HBO has the ability to drastically increase the partial pressure of oxygen in the tissues of the body. The oxygen partial pressures achievable using HBO is much higher than those achievable while breathing pure oxygen at normobaric conditions (i.e., at normal atmospheric pressure, 0.101325 MPa) [7]. In ophthalmology HBO is beneficial for diabetic retinopathy and CRAO patients [8,9].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Neovascularization on Human Retinal Pigment Epithelium after Hyperbaric Oxygen Therapy

Chen¹,

Chao²

2017

Health Sci J

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Objective: To investigate the neovascularization effect of hyperbaric oxygen (HBO) therapy on human retinal pigment epithelium (REP) cells. Methods:Human REP cells were cultured in vitro, and divided into normoxic control group and hypoxic control group randomly. The experimental groups were then divided into three subgroups via the different HBO pressure, 0.15 MPa exposed group, 0.2 MPa exposed group, and 0.25 MPa exposed group. The experimental groups were exposed to 100% pure oxygen for 60 and 90 minutes twice, with a 24 hours interval. After HBO exposure the expression of pigment epithelium-derived factor (PEDF) and tumor necrosis factor alpha (TNF-α) by RPE cells were measured by western blot. Results:The western blot result showed that the level of PEDF expression in both experimental groups had an increased trend as the pressure increases with statistical significance (P<0.01). The expression of PEDF in the normoxic group was higher than the hypoxic group. The results showed that the level of TNF-α expression by RPE cells in both experimental groups have a decrease trend as the pressure increases with statistical significance (P<0.01). The results showed that the expression of TNF-α in the hypoxic group was higher when compared to the normoxic group. The duration of HBO exposure has no statistical significance on the level of PEDF and TNF-α expression. Conclusion:This study supports the idea that HBO increases the release of PEDF by RPE cells whither in normoxic and hypoxic conditions, and decreases the release of TNF-α by RPE cells in both conditions, especially in hypoxic state. We also found that HBO can raise the level of PEDF and decrease the level of TNF-α in RPE cells, and has an anti-angiogenic effect which can suppress the formation of neovascularization.

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“…A case of central retinal artery occlusion secondary to bilateral buried optic nerve drusen at high altitude was reported in 1995 [ 5 ], while another case of central retinal artery occlusion caused by the expansion of intraocular gas during mountain travel at high altitude was reported in 2002 [ 6 ]. A recent report has shown that cilioretinal artery occlusion and related central retinal vein occlusion occurred as a complication following high-altitude exposure [ 7 ]. It has been speculated that the reason for a few reports of retinal artery occlusion secondary to high-altitude exposure might be that some clinicians do not master the pathogeny of retinal vascular occlusion, thus do not inquire the patient’s travel history or consider high altitude as a risk factor.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have shown that HBO treatment is a safe, manageable, low-cost, and effective treatment for retinal artery occlusion [ 7 ]. HBO treatment have an effect on visual outcome in patients with BRAO [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Branch retinal artery occlusion secondary to high-altitude exposure and diabetic retinopathy: a case report

Xue¹,

Wang²,

Wang³

et al. 2020

BMC Ophthalmol

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Background To report a case of branch retinal artery occlusion (BRAO) secondary to high-altitude exposure and diabetic retinopathy (DR), and to characterize the retinal changes before and after hyperbaric oxygen (HBO) treatment. Case presentation We present a case of a 42-year-old man with DR who travelled to Tibet (in China, 3800 m/12467 ft. above mean sea level). The day after the end of his journey, the patient presented with acute, painless visual loss and visual field loss in his left eye. He was then diagnosed with BRAO, which is an acute blockage of blood flow. After HBO treatment, visual acuity and visual field were improved. Conclusions High-altitude exposure and DR may be considered as relevant risk factors for BRAO. The ophthalmologist should be aware that the BRAO might be a rare presenting sign of high-altitude retinopathy (HAR), particularly in patients with DR. HBO treatment can be considered as a choice for ophthalmologists on treatment against BRAO.

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Late Hyperbaric Oxygen Treatment of Cilioretinal Artery Occlusion With Nonischemic Central Retinal Vein Occlusion Secondary to High Altitude

Abstract: CRVO related CRAO should be regarded as a rare complication of exposure to high altitude and HBO seems to be the treatment of choice of high altitude related co-occurence of CRVO and CRAO in the late period.

Cited by 9 publications

References 12 publications

Oxygen therapy in patients with retinal artery occlusion: A meta-analysis

Oxygen therapy in patients with retinal artery occlusion: A meta-analysis

The Effect of Neovascularization on Human Retinal Pigment Epithelium after Hyperbaric Oxygen Therapy

Branch retinal artery occlusion secondary to high-altitude exposure and diabetic retinopathy: a case report

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