Effect of hyperbaric oxygen treatment in central retinal artery occlusion

BACKGROUND: Central retinal artery occlusion (CRAO) is a rare and serious ophthalmologic emergency with a bad prognosis. Hyperbaric oxygen (HBO2) treatment has been reported to improve visual acuity of CRAO patients. However, there are unknown variables for HBO2 treatment such as initiation period, number of sessions and efficacy. In this study, we aimed to investigate efficacy of HBO2 treatment in CRAO patients. METHODS: Patients who had been diagnosed with CRAO and referred to our Hyperbaric Oxygen Treatment Unit with the indication of HBO2 treatment were included in the study. Patient demographics, their systemic diseases, best-corrected visual acuity (BCVA) and the time of visual loss were recorded. Oral acetazolamide and topical beta blocker treatments as well as HBO2 treatments were administered to patients as soon as possible. Patients received 20 treatments as standard. Visual acuity was examined and recorded following each HBO2 treatment administration. RESULTS: 10 eyes (five right, five left) of 10 patients) were included in the study. While average visual acuity was LogMAR 3 before the treatment, it was measured as LogMAR 1.8 on average after treatment (P ⟨ 0.05). None of the patients were observed to have neovascular glaucoma. CONCLUSIONS: HBO2 treatment is an efficacious method with few side effects and can be used in the treatment of CRAO patients. During acute and subacute periods a certain number of HBO2 treatment sessions may be beneficial. Stopping treatments before eight completed HBO2 sessions for a patient who did not show improvement until that time may miss a patient who would have benefited from HBO2 treatment.