Hyperbaric Oxygen Treatment Improves Non-Arteritic Central Retinal Artery Occlusion: an Observational Retrospective Study
Naser Haj Aissa1, Majesta Hovingh1, Laurel Packard1, Asad Ahrar1, Malgorzata Miller1, Nadeem Khan1, Nabil Wees1, Jiangyong Min1
1Corewell Health West/MSU
Objective:
We aim to investigate the benefit of hyperbaric oxygen therapy (HBOT) in patients with central retinal artery occlusion (CRAO) compared to conservative management.
Background:
CRAO is a form of acute ischemic stroke that causes severe visual loss, which is a relatively rare emergency but devastating condition. There is currently no guideline-endorsed treatment. Data on HBOT for CRAO is minimal.
Design/Methods:
We conducted a retrospective single-center study that recruited patients with diagnosed non-arteritic CRAO from January 2019 - May 2024. HBOT was offered to patients who presented within 24 hours from symptom onset. Eight patients underwent a full course of HBOT (twice a day for five days). Twelve patients received partial HBOT (1 to 7 treatments); HBOT discontinued per patients' request due to either anxiety or no noted visual improvement. Twenty-seven patients did not undergo HBOT due to being outside treatment window or patients declined HBOT. The primary outcome was visual improvement at the time of discharge. Paired T-test was used to compare the change in LogMAR best-corrected visual acuity (BCVA) in patients before and after HBOT.
Results:
Patients who completed the full HBOT course showed significant improvement using LogMAR BCVA from 2.7±0.3 pre-HBOT to 2.2±0.4 post-HBOT (p=0.003). No significant changes were observed in the partial HBOT group (2.4±0.6 to 2.2±0.5, p=0.52) or the non-HBOT group (2.3±0.5 pre and post, p=0.36). Only one patient experienced a seizure during HBOT, with no other complications reported. Demographics and vascular risk factors showed no significant differences among the three groups.
Conclusions:
HBOT improves visual outcomes in CRAO patients who complete full therapy, but partial HBOT does not provide similar benefits. Our results suggests that HBOT is safe and should be offered to CRAO patients who present to the hospital within 24 hours of symptom onset. A large-scale prospective study is needed to validate our retrospective results.
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