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Amina I. Malik, Karl C. Golnik; Hyperbaric Oxygen Therapy in the Treatment of Radiation Optic Neuropathy. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3896.
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Radiation optic neuropathy is an uncommon but sight threatening entity. Hyperbaric oxygen therapy has been attempted in these patients, but there remains controversy over its efficacy. The purpose of our study is to describe a case series of four consecutive patients who presented with unilateral or very asymmetric radiation optic neuropathy (RON) who underwent treatment with hyperbaric oxygen (HBO) and oral corticosteroids.
A retrospective chart review was performed on four patients who developed unilateral or very asymmetric RON and had bilateral optic nerve enhancement on MRI. Patients were treated with HBO and oral corticosteroids. Patient age, concurrent chemotherapy use, history of diabetes mellitus (DM), dose of radiation, interval from radiation to onset of visual loss, interval from onset of visual loss to treatment, change in visual acuities, MRI findings, optic disc appearance and Humphrey visual field results were documented.
Total radiation dose varied from 3500 cG to 7020 cG. Fractionated radiation dose ranged from 180 cG to 260 cG. Initially, all patients had superior arcuate scotomas in the minimally affected eye. Interval from symptom onset to treatment ranged from 7 days to 3 months. Three of the four patients had preservation of vision in the minimally affected eye. One patient progressively lost vision in the minimally affected eye despite treatment.
Our series of patients suggests that prompt treatment with HBO and oral corticosteroids may result in visual preservation in the contralateral minimally affected eye despite the presence of optic nerve enhancement on MRI.
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