Authors (including presenting author) :
Au CL(1), Chong SSY(1), Leow PL(1), Ko CKL(1)
Affiliation :
(1)Department of Ophthalmology, Hong Kong East Cluster Ophthalmic Service, Hospital Authority, Hong Kong
Introduction :
Hong Kong first established the hyperbaric oxygen therapy (HBOT) for treatment of central retinal artery occlusion (CRAO) since November 2018. This territory wide tertiary referral service was not interrupted even under the COVID-19 pandemic. CRAO aka ocular stroke is a rare but blinding eye disease, there was no registered randomized controlled trial on HBOT treatment for CRAO so far.
Objectives :
This study aims to review the treatment effect and complications of HBOT for CRAO in our locality.
Methodology :
Patients diagnosed CRAO with symptom (acute blindness) onset ≤ 6 hours, who failed emergency bedside ocular treatments, would be recruited for a course of HBOT situated in a tertiary hospital receiving territory-wide CRAO referrals from both public and private practitioners within Hong Kong 24-hour every day. Patients' demographics, diseased eye characteristics, HBOT details and treatment outcomes were reviewed in October 2021 for the 33-month service period. Statistical analyses were done by SPSS.
Result & Outcome :
53 patients aged 67.3 ± 13.3 years old (27 – 89) were included, 96.2% were Chinese, with male-to-female ratio of 1.4 : 1. Mean follow up period was 166.5 days (1 week – 33 months). 27 left eyes (50.9%) and 26 right eyes (49.1%) were investigated, on average each patient received 8.6 (1 — 10) sessions of HBOT. Visual acuity (VA) by Snellen chart were mostly over non-numerical range, of hand movement and finger counting. Absolute VA improvement was observed in 40 patients (75.5%), with 12 eyes (22.6%) having no improvement despite the whole course of HBOT, and 1 eye experienced even drop in VA. 33 patients (62.3%) developed complications during treatment: 2 cerebral stroke, 1 convulsion, 1 confusion, 1 sinus pain, 2 hypoglycaemia, 1 shortness of breath. 22 patients (41.5%) failed to equalize the pressure during treatment, and required myringotomy or even grommet insertion.
Conclusion: HBOT is promising to CRAO patients to regain vision for navigation, with 3 quarters of eyes having VA improvement. Commonest complication was barotrauma, and severe complications were rare.
