Hadanny A, Maliar A, Fishlev G, Bechor Y, Bergan J, Friedman M, Avni I, Efrati S, et al.
Clinical ophthalmology (Auckland, N.Z.). Date of publication 2016 Dec 29;volume 11():115-125.
1. Clin Ophthalmol. 2016 Dec 29;11:115-125. doi: 10.2147/OPTH.S121307.
eCollection 2017.
Reversibility of retinal ischemia due to central retinal artery occlusion by
hyperbaric oxygen.
Hadanny A(1), Maliar A(2), Fishlev G(2), Bechor Y(2), Bergan J(2), Friedman
M(2), Avni I(3), Efrati S(4).
Author information:
(1)Sagol Center for Hyperbaric Medicine and Research, Assaf Harofeh Medical
Center, Zerifin, Israel; Sackler School of Medicine, Tel-Aviv University,
Tel-Aviv, Israel.
(2)Sagol Center for Hyperbaric Medicine and Research, Assaf Harofeh Medical
Center, Zerifin, Israel.
(3)Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel;
Opthalmology Department, Assaf Harofeh Medical Center, Zeirifin, Israel.
(4)Sagol Center for Hyperbaric Medicine and Research, Assaf Harofeh Medical
Center, Zerifin, Israel; Sackler School of Medicine, Tel-Aviv University,
Tel-Aviv, Israel; Research and Development Unit, Assaf Harofeh Medical Center,
Zerifin, Israel; Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv,
Israel.
PURPOSE: Ischemic retinal damage can be reversed by hyperbaric oxygen therapy
(HBOT) as long as irreversible infarction damage has not developed. However, the
time window till irreversible damage develops is still unknown. The study aim
was to evaluate the effect of HBOT and determine possible markers for
irreversible retinal damage.
MATERIALS AND METHODS: Retrospective analysis of 225 patients treated with HBOT
for central retinal artery occlusion (CRAO) in 1999-2015. One hundred and
twenty-eight patients fulfilled inclusion/exclusion criteria: age >18 years,
symptoms <20 hours, and best-corrected visual acuity (BCVA) <0.5 logMAR.
RESULTS: Time delay from symptoms to treatment was 7.8±3.8 hours. The BCVA was
significantly improved after HBOT, from 2.14±0.50 to 1.61±0.78 (P<0.0001). The
proportion of patients with clinically meaningful visual improvement was
significantly higher in patients without cherry-red spot (CRS) compared to
patients with CRS at presentation (86.0% vs 57.6%, P<0.0001). The percentage of
patients with final BCVA better than 1.0 was also significantly higher in
patients without CRS vs patients with CRS at presentation (61.0% vs 7.1%,
P<0.0001). There was no correlation between CRS and the time from symptoms. HBOT
was found to be safe, and only 5.5% of patients had minor, reversible, adverse
events.
CONCLUSION: HBOT is an effective treatment for non-arteritic CRAO as long as CRS
has not formed. The fundus findings, rather than the time delay, should be used
as a marker for irreversible damage.
DOI: 10.2147/OPTH.S121307
PMCID: PMC5207437
PMID: 28096655
Conflict of interest statement: The authors report no conflicts of interest in
this work.
