Mitch,

It was nice talking with you this morning, and Thank you for your question. As we discussed, Central Retinal Artery Occlusion (CRAO) and Acute Peripheral Arterial Insufficiency (APAI) are completely different diagnoses.

Central retinal artery occlusion (CRAO) is an emergent rare eye disorder that typically produces sudden, severe, painless, and irreversible vision loss in the affected eye. Patients at risk include those with giant cell arteritis, atherosclerosis, and thromboembolic disease. Once the arterial supply to the retina is occluded, variable degrees of tissue loss may occur within 90 to 120 minutes. Medicare does not cover this indication but may be covered by commercial carriers. Medicare patients must sign an Advanced Beneficiary Notice (ABN) to receive HBO treatment.

Acute Peripheral ischemias cover a spectrum of diseases that includes acute traumatic and non-traumatic events sharing the common feature of sudden occlusion of the arterial supply. The diagnosis of acute peripheral arterial insufficiency (APAI) is an accepted indication for HBOT. Anything other than an acute arterial embolic event (including severe peripheral vascular disease at risk of extremity amputation) would not be an acceptable indication for HBOT.

Please let me know if you have any additional thoughts or questions.

Have a great day! Jeff