Abstract
Purpose :
Central retinal artery occlusions (CRAO) have a poor prognosis despite treatment. The treatment and treatment window are controversial, with no consensus on the best way to manage such patients. The purpose of our study was to evaluate our experience using hyperbaric oxygen therapy (HBO) to treat CRAOs.
Methods :
A retrospective chart review of consecutive patients with a diagnosis of CRAO treated with HBO over a 5-year period at one hospital was performed. HBO was performed within 24 hours of vision loss. Diagnosis was confirmed on ophthalmoscopic examination. Snellen visual acuities were recorded before and after HBO and converted to decimal equivalents for statistical analysis.
Results :
6 patients with a CRAO were identified with one patient having cilio-retinal artery involvement. Mean time of HBO from vision loss was 11.5 hours (range 2.5-15.0 hours). Mean decimal equivalent visual acuities before and after HBO were 0.0015 (range NLP to HM) and 0.013 (range NLP to 20/300), respectively (t-test, p=0.3621). Of the 3 patients whose vision improved post-HBO, two improved by 1 line and 1 by two lines. Mean time to HBO treatment for those patients that improved versus those that did not was 9.83 hours versus 13.17 hours, respectively (t-test, p=0.4779).
Conclusions :
Visual acuity improved in 50% of CRAO eyes treated with HBO and those patients with visual acuity improvement had earlier HBO treatment compared to those that did not have visual acuity improvement. Despite these positive findings in favor of HBO and earlier HBO, the differences were not found to be statistically significant. Further investigation is needed to further clarify the role of HBO in the treatment of CRAO, including the most effective timing for this treatment.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.