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SS Purohit, BR Wong, K Corsan CHT; Treatment of Retinal Artery Occlusion with Hyperbaric Oxygen at the University of Texas Medical Branch at Galveston . Invest. Ophthalmol. Vis. Sci. 2002;43(13):505.
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Purpose: Central retinal artery occlusion is a true ophthalmic emergency necessitating prompt treatment to avoid permanent visual loss. Such treatments vary in the literature, but one treatment with selected documented success includes the use of hyperbaric oxygen. The purpose of the study is to describe the UTMB-Galveston Hyperbaric Oxygen Chamber experience and to demonstrate hyperbaric oxygen to be a viable tool in selected individuals for the treatment of central or branch retinal artery occlusion (CRAO/BRAO). Methods: A retrospective chart review with n=18 total patients receiving treatments from 1995-present was performed. Criteria logged included visual acuity at presentation, after hyperbaric oxygen treatments, final follow-up visit, and also by the time frame between visual loss and presentation to ophthalmologist for hyperbarics consideration. Patients on average received 5 treatments (range 5-20). The treatments were usually at 2.2 ATA (range 2.0-2.36 ATA). Dive time was on average 90 minutes per session. Hyperbaric parameters were logged according to protocol. Results: Patients who presented acutely (within hours) of an arterial occlusive event may benefit the greatest from hyperbarics. In some cases, full visual acuity was recovered after the minimum number of hyperbaric dives and was maintained at long term follow-up. Previous reports have stated hyperbaric oxygen is usually only beneficial to patients within 90 minutes of an occlusive event; however, our series shows that patients even up to several hours after an occlusive event did recover useful vision. However, delay greater than 24 hours did carry poor visual prognosis with a greater number of dives needed, which carried other risks related to the hyperbaric treatment itself. Conclusion: Hyperbaric oxygen is a valid treatment modality in patients who present acutely after visual loss occurring from a CRAO/BRAO. In some cases, total visual acuity can be recovered. Our case series at the UTMB Hyperbaric Center elucidated again the need for prompt medical attention and awareness of referral to hyperbarics as soon as possible to save permanent visual loss.
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