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C. J. Hwang, S.-H. Chang, R. Douglas, R. Goldberg; Hyperbaric Oxygen Therapy for Acute Post-Surgical or Post-Traumatic Optic Neuropathy. Invest. Ophthalmol. Vis. Sci. 2010;51(13):4880.
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The management of acute post-surgical or post-traumatic optic neuropathy is not standardized and current treatment is sub-optimal. Hyperbaric oxygen therapy has been used for several years in the treatment of various acute and chronic disorders including brain injury and hearing loss. The purpose of our study is to evaluate the effect of adjunctive hyperbaric oxygen therapy in patients with acute post-surgical or post-traumatic optic neuropathy.
Four patients with acute post-surgical or post-traumatic optic neuropathy were identified and treated with hyperbaric oxygen therapy between November 2008 and November 2009 at the Jules Stein Eye Institute. All patients underwent full ophthalmic evaluation before, during, and after hyperbaric oxygen treatment. Patients also received high dose intravenous corticosteroids. All hyperbaric oxygen treatment was initiated within 24 hours of injury and performed by the Hyperbaric Medicine team at the University of California, Los Angeles following the same protocol.
Hyperbaric oxygen therapy appeared to improve patients’ visual acuity and color vision during hyperbaric oxygen therapy with long term improvement outside the chamber. Upon further hyperbaric oxygen treatments, the improvement in vision stabilized. Once stabilization of vision occurred, hyperbaric oxygen therapy was discontinued, with no decline in visual improvement. One patient had no light perception vision upon the initiation of treatment and had no visual recovery; however the other patients had improvement in both color vision and visual acuity by at least 5 lines.
Hyperbaric oxygen therapy may potentially improve the recovery of acute post-surgical or post-traumatic optic neuropathy. We recommend the use of hyperbaric oxygen therapy in cases where vision is at least light perception. In addition, initiation of hyperbaric oxygen therapy should be performed as soon as possible.
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