Outcomes of hyperbaric oxygen therapy for central retinal artery occlusion in Somdech Phra Pinklao Hospital
Keywords:
Acute central retinal artery occlusion, hyperbaric oxygen therapy, acute visual lossAbstract
Background: Central retinal artery occlusion (CRAO) is an emergency condition of the eye. Patients with CRAO will present with painless sudden visual loss. The condition requires timely management for reversal of vision. Currently, there are no approved treatments of choices that provide highly reliable outcome. Examples of current available treatments are hyperbaric oxygen therapy (HBOT), decreasing intraocular pressure (IOP), vasodilatation and thrombolytic agent. HBOT is recommended for acute non-arteritis CRAO by the Undersea and Hyperbaric Medical Society (UHMS) and the European Committee for Hyperbaric Medicine.
Objective: To evaluate the outcome of central retinal artery occlusion (CRAO) treatment by hyperbaric oxygen therapy (HBOT) and its complications at the Somdech Phra Pinklao Hospital.
Method: This is a retrospective descriptive study. The subjects included forty-one patients with central retinal artery occlusion (CRAO) who received hyperbaric oxygen therapy (HBOT). Data was collected retrospectively from medical records and analyzed using Fisher’s exact test to compare the visual acuity between pre-HBOT and post final HBOT.
Results: The finding showed that 19 (46.3%) patients with CRAO had visual improvement after HBOT. Fifteen (60.0%) of patients underwent HBOT within 24 hours following visual loss and 4 (25.0%) of patients underwent HBOT after 24 hours following visual loss had improved visual outcomes. Moreover, 12 patients (29.3%) experienced complications from HBOT; 11 patients (26.8%) with the middle ear barotrauma and 1 patient (2.4%) with pulmonary oxygen toxicity.
Conclusion: HBOT is an effective treatment for non-arteritis CRAO. Visual acuity was improved by HBOT especially in those who were treated with HBOT within 24 hours from the visual loss onset.
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