Evaluation of Retinal Arterial Occlusion and its Visual and Systemic Prognosis after Hyperbaric Oxygen Therapy

Fritz Gerald P Kalaw; Nicholas Chartrand; Lauren Wedekind; Jimmy S Chen; Andrew C Lin; Zachary Koretz; Leo Meller; Michael Oca; Vasan Jagadeesh; Katherine Wilson; Evan Walker; William R Freeman; Christopher B Toomey

doi:10.1097/IAE.0000000000004253

Evaluation of Retinal Arterial Occlusion and its Visual and Systemic Prognosis after Hyperbaric Oxygen Therapy

Retina. 2024 Aug 14. doi: 10.1097/IAE.0000000000004253. Online ahead of print.

Authors

Fritz Gerald P Kalaw^{1

2

3}, Nicholas Chartrand⁴, Lauren Wedekind⁵, Jimmy S Chen², Andrew C Lin², Zachary Koretz², Leo Meller⁵, Michael Oca⁵, Vasan Jagadeesh⁵, Katherine Wilson⁵, Evan Walker², William R Freeman^{1

2}, Christopher B Toomey^{1

2

6}

Affiliations

¹ Jacobs Retina Center, University of California San Diego, California, United States of America, 92093.
² Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, California, United States of America, 92093.
³ Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, California, United States of America, 92093.
⁴ College of Medicine, University of Arizona, Phoenix, Arizona, United States of America, 85004.
⁵ School of Medicine, University of California San Diego, United States of America 92093.
⁶ Glycobiology Research and Training Center, University of California San Diego, California, United States of America, 92093.

PMID: 39163734
DOI: 10.1097/IAE.0000000000004253

Abstract

Purpose: To evaluate the systemic and ocular outcomes of patients with branch retinal artery occlusion (BRAO) and central retinal artery occlusion (CRAO) after hyperbaric oxygen therapy (HBOT).

Methods: This is a single-institution study of 75 subjects diagnosed with BRAO (28, 37.3%) and CRAO (47, 62.7%) who visited the emergency department or stroke clinic. Twenty-seven (36%) subjects received HBOT on initial presentation (BRAO-14.3%, CRAO-48.9%). The primary outcome was the best corrective visual acuity (BCVA) change in non-HBOT and HBOT subjects. Secondary outcomes included subsequent development of an acute cerebrovascular accident (CVA)/stroke or neovascular glaucoma (NVG).

Results: Overall BCVA did not change from the initial presentation to the final timepoint (logMAR 1.5) in either the conservative management or HBOT cohorts for either BRAO subjects (non-HBOT-logMAR 0.4 vs. 0.6, p=0.658; HBOT-logMAR 0.1 vs. 0.4, p=0.207) or CRAO subjects (non-HBOT-logMAR 2.1 vs. 2.2, p=0.755; HBOT-logMAR 2.1 vs. 2.0, p=0.631). Seven (9.3%) subjects developed CVA (BRAO: non-HBOT-4.2% and HBOT-25.0%, p=0.207; CRAO: non-HBOT-16.7% and HBOT-4.3%, p=0.348) and five subjects (6.7%) developed NVG (BRAO: non-HBOT-4.2% and HBOT-0%, p=1.00; CRAO: non-HBOT-16.7% and HBOT-0%, p=0.109).

Conclusions: Our findings suggest that HBOT does not significantly improve BCVA or mitigate the subsequent development of stroke and NVG in patients with RAOs.