I recently had a patient referred for treatment of retinal artery occlusion (RAO), which gives me the opportunity to discuss this disorder and explore the role of hyperbaric oxygen therapy.
Although RAO is not very common, it is not rare either and when it occurs a person with otherwise good vision abruptly and unexpectedly goes blind in one eye. RAO is, in essence, a stroke of the eye. Patients typically present with sudden, severe, and painless loss of vision. RAO is mostly seen in people in their 60’s who frequently have high blood pressure, diabetes, atrial fibrillation or other problems that increase the risk of stroke. This link shows a picture of the aftermath of what the retina looks like.
What is the evidence that hyperbaric oxygen therapy helps RAO? The best evidence comes from an Israeli study. The authors studied 35 patients treated with hyperbaric oxygen and compared them to 37 not treated with hyperbaric oxygen. The authors tried to treat the patients as soon after the onset of symptoms as possible. More than 80% of the hyperbaric oxygen treated patients had improvement of visual acuity, whereas fewer than a third of the controls improved. The authors concluded that hyperbaric oxygen treatment of RAO patients was highly effective, if given less than 8 hours after the onset of symptoms.
We will see what happens with my patient. There are many diseases that might be helped by treatment with hyperbaric oxygen, but most patients are never referred.