Purchase this article with an account.
Masayuki Yasuda, Hajime Sato, Kazuki Hashimoto, Noriyuki Suzuki, Takehiro Hariya, Hiroko Nakayama, Toshifumi Asano, Masanori Munakata, Toru Nakazawa; Efficacy of hyperbaric oxygen treatment for central retinal artery occlusion and factors associated with its visual outcome. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4294.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Central retinal artery occlusion (CRAO) is an ophthalmic emergency associated with severe painless vision loss. Despite the various advocated measures, there is no proven effective treatment for CRAO. Several studies have suggested the efficacy of hyperbaric oxygen treatment (HBOT) in CRAO. We thus evaluated treatment efficacy of HBOT for CRAO and factors associated with visual prognosis after HBOT.
Fifty-eight eyes from 58 CRAO patients (median age 72 years [interquartile range = 64-81], 35 men and 23 women) who visited Tohoku Rosai Hospital were included in this retrospective study. The patients with CRAO underwent hyperbaric oxygen treatment (1 hour daily for 5 consecutive days) combined with intravenous infusion of alprostadil (Prostaglandin E1), oral administration of niceritrol (nicotinic acid analogue), and topical administration of Travoprost. Best-corrected visual acuity (BCVA) was measured before HBOT and at 2 and 6 weeks after HBOT. All BCVAs in decimal numbers were converted to the logarithm of the minimum angle of resolution (LogMAR) units for all analyses. Blood test and carotid artery evaluation with ultrasound were performed in each patient. BCVA at each visit were compared using the Wilcoxon signed-rank test with Bonferroni correction. Relationships between the variables were evaluated with Spearman correlation. Multivariate linear regression analysis was performed to investigate factors associated with BCVA after HBOT.
LogMAR BCVA were significantly improved after HBOT (baseline vs 2 weeks: P=4.90E-6, 2 weeks vs 6 weeks: P=0.001). Changes in logMAR BCVA from baseline to 6 weeks after HBOT was 0.45±0.68, which is greater than clinically significant improvement (i.e. 0.3 logMAR change). LogMAR BCVA at 6 weeks was significantly correlated to baseline LogMAR BCVA. Multiple logistic regression analysis showed that baseline logMAR BCVA (β=0.58, P=7.40E-7), days after onset of symptoms (β=0.30, P=0.0048), and maximum intima-media thickness of the common carotid artery (IMT-Cmax) (β=0.25, P=0.029) were significantly associated with logMAR BCVA at 6 weeks after HBOT.
HBOT would be suggested to be an effective treatment option for CRAO. In addition, baseline BCVA, days after onset, and IMT-Cmax might be useful marker for prediction of visual outcome in CRAO after HBOT.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
This PDF is available to Subscribers Only