Visual Outcomes Following Hyperbaric Oxygen Therapy in Acute Central Retinal Artery Occlusion Patients

Abstract

Purpose: To evaluate the efficacy of a novel HBOT protocol, characterized by specific pressure levels and treatment duration in patients with CRAO patients presenting within 24 hours, compared to a non-HBOT cohort. Patients and methods: This retrospective cohort study included patients diagnosed with CRAO presenting within 24 hours from October 2003 to March 2022. Patients treated with intravenous recombinant tissue plasminogen activator (rt-PA) or experiencing treatment-related visual complications were excluded. Of 49 eligible patients, 17 underwent HBOT following the novel protocol, while 32 received standard care (non-HBOT). Results: Baseline logMAR VA was 2.3 in both groups. At discharge, 76.5% of the HBOT group exhibited a VA improvement of at least 0.3 logMAR, compared to 40.6% in the non-HBOT group (p = 0.02). Mean logMAR VA at discharge was 1.4 ± 0.8 in the HBOT group and 2.0 ± 0.8 in the non-HBOT group. After one month, the mean logMAR VA remained at 1.4 ± 0.9 in the HBOT group and was 1.9 ± 0.9 in the non-HBOT group. Conclusion: While constrained by the small sample size and short-term outcome data, these results showed the benefits of this unique HBOT protocol in CRAO presenting within the critical 24-hour window. Nevertheless, further prospective validation is necessary before widespread clinical adoption.