Oxygen therapy in patients with retinal artery occlusion: A meta-analysis

Xiao-dong, WU; Chen, Shuangshuang; Li, Shizun; Zhang, Ji; Luan, Di; Zhao, Shoucai; Chu, Zhonghua; Xu, Yang

doi:10.1371/journal.pone.0202154

Cited by 33 publications

(32 citation statements)

References 29 publications

(27 reference statements)

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“…e median number of HBOT sessions is also a parameter that contributes to the analysis of the e cacy of this therapeutic option. e median number of our study, which corresponds to a total of 10.5 h of treatment, is in line with what Wu et al reported in his recent meta-analysis of seven randomized controlled trials (251 eyes, with the most e ective treatment length over 9 hours) [6]. It is also noteworthy that, according to UHMS, the optimum number of HBOT sessions depends on the severity and duration of the patients' symptoms and the degree of response to them.…”

Section: Discussionsupporting

confidence: 89%

“…is study also stands out for including the comparison between a group under HBOT, a group under normobaric oxygen and a group not submitted to oxygen therapy, as well as the result of traditional therapies. Oxygen therapy groups were more likely to have visual improvement (5.61x more); the group under HBOT presented better nal visual outcome and with statistical signi cance; there was no statistical signi cance between HBOT alone and combined treatment with traditional therapies, nor between the CRAO and BRAO groups (despite both groups presented favorable visual outcomes) [6].…”

Section: Conflicts Of Interestmentioning

confidence: 90%

“…Retinal artery occlusion (RAO) is a rare ophthalmological emergency, with embolism being the most common aetiology [1][2][3][4]. It is manifested by acute painless monocular vision loss and a meaningful visual improvement (three lines in Snellen chart) is expected only in 10% of the cases [1][2][3][4][5][6][7]. e time of ischemia is classically the critical prognosis factor for the visual outcome, considering that the retina is the tissue of the human body with the highest oxygen consumption, being therefore very sensitive to variations in oxygen [1,4,8,9].…”

Section: Introductionmentioning

confidence: 99%

“…RAO remains without approved treatment and traditional options are not e ective enough, having globally a nonsignificant visual outcome improvement [4,6].…”

Section: Introductionmentioning

confidence: 99%

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Hyperbaric Oxygen Therapy in Retinal Arterial Occlusion: Epidemiology, Clinical Approach, and Visual Outcomes

Lopes

Basto

Henriques

et al. 2019

Case Reports in Ophthalmological Medicine

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properly cited.Purpose. To evaluate the e cacy and safety of hyperbaric oxygen therapy (HBOT) in patients with acute retinal artery occlusion (RAO). Secondarily, to analyse the epidemiology and the clinical approach. Methods. Retrospective study of 13 patients submitted to HBOT between 2013 and 2018. e analysed parameters consisted of: systemic history, time between symptoms onset and treatment, initial approach, number of HBOT sessions, complications of HBOT and best corrected visual acuity-BCVA (of the total sample, central RAO-CRAO-group, and branch RAO-BRAO group). Results. Arterial hypertension was the most prevalent systemic risk factor (53.8%). Initial therapies were 100% normobaric oxygen administration, topical and oral hypotensive medication, eye massage and aspirin. CRAO was observed in 69.2% and BRAO in 30.8% of the cases, with clinically signi cant visual improvement (a decrease in logMAR of 0.3) in 55.5% and 75%, respectively. Time between symptoms onset and treatment had a median of 9 hours. e median number of HBOT sessions was 7, without complications. Conclusions. HBOT provide BCVA improvement in patients with RAO, when it is performed in an early time a er the symptom onset. It seems to be an e ective and safe therapeutic option for a pathology that still remains without approved treatment.

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Section: Discussionsupporting

confidence: 89%

Section: Conflicts Of Interestmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

“…RAO remains without approved treatment and traditional options are not e ective enough, having globally a nonsignificant visual outcome improvement [4,6].…”

Section: Introductionmentioning

confidence: 99%

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Hyperbaric Oxygen Therapy in Retinal Arterial Occlusion: Epidemiology, Clinical Approach, and Visual Outcomes

Lopes

Basto

Henriques

et al. 2019

Case Reports in Ophthalmological Medicine

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“…The patient was also treated with high flow oxygen inspiration and hyperbaric oxygen immediately after CRAO diagnosis. In patients with CRAO, oxygen therapy showed beneficial effects, especially when 100% oxygen and hyperbartic oxygen were administrated, which were proved to improve VA in CRAO patients significantly [15]. As an efficacious, well-tolerated and few-side-effects therapeutic method, hyperbaric oxygen can be used in treatment of acute and subacute CRAO patients, but also it is recommended as emergent therapeutic option [16][17][18].…”

Section: Conclusion and Literature Reviewmentioning

confidence: 99%

Transient visual acuity loss after spine surgery in prone position: A case report and literature review

Xiong

Guo²,

Hu³

et al. 2020

Preprint

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KEYWORDS 2 postoperative visual loss, visual acuity, ischemic optic neuropathy, retinal artery occlusion, prone position, spine surgery Abstract Background: Visual loss after spine surgery in prone position is disastrous postoperative complication because it is almost irreversible. Meamwhile, there is no optimal treatments and recommended peofessional guidelines. Case presentation: A 43 years old male patient complained visual loss after spine surgery in prone position. Immediate ophthalmic consultation undoubtedly considered central retinal artery occlusion, therefore combined therapies were administered including neurotrophy, anticoagulation, vasodilation and adequate fluid infusion, followed by hyperbaric oxygen treatment. After active treatment, his visual acuity recovered from postoperative 5 hours gradually. Conclusion: Because there is shortage of efficacious treatment against visual loss after spine surgery in prone position, the best method avoiding this complication is to pay great attention and prevent it. Background Visual loss after spine surgery in prone position is a rare complication, this incidence is about 0.017 to 1% [1, 2]. Although rare, it is potentially disastrous postoperative complication, even irreversible. Visual loss after spine surgery is attributable to various risk factors, including excessive blood loss, long prone spine surgery, hypoxia, use of vasoconstrictors, hypotension, high venous pressure, high volume fluid replacement, and poor head positioning [3]. These risks might lead to ischemic optic neuropathy (ION), central retinal artery occlusion (CRAO) and retinal vein occlusion. It has been reported patients with carotid stenosis or occlusion is also more vulnerable to this complication than those without stenosis [4]. Although CRAO and ION might be the ordinal mechanisms of postoperative visual loss (POVL) [5], the exact pathophysiologic mechanism has not been revealed [6]. Now we presented a case suffering transient unilateral visual loss after spine surgery in prone position under general anesthesia (GA), although who was without these recognized perioperative risk factors. Because of timely diagnosis and therapy, his visual acuity (VA) mostly resolved soon. This was a lucky case because of very quick recovery, which different from the most reported cases. Meanwhile possible etiologies and effective treatments were analyzed for avoiding this complication in future. Case PresentationA 43-year-old man was admitted with complain of repeated numb and pain on left low limb and

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