Hyperbaric oxygen treatment of central retinal vein occlusion with cilioretinal artery occlusion secondary to hormonal treatment: Case report and review

Abstract

(Khallouli A, Khelifi K, Saidane R, Choura R, Maalej A, Ben Sassi R. Hyperbaric oxygen treatment of central retinal vein occlusion with cilioretinal artery occlusion secondary to hormonal treatment: Case report and review. Diving and Hyperbaric Medicine. 2020 December 20;50(4):431–436. doi: 10.28920/dhm50.4.431-436. PMID: 33325028.) Introduction: This report describes a case of central retinal vein occlusion (CRVO) and cilioretinal artery occlusion (CLRAO) after hormonal treatment for induction of ovulation that was successfully treated with hyperbaric oxygen. Case report: A 48 year-old woman was admitted to our department for sudden blurred vision in her left eye. The patient had a history of 3-months hormonal treatment for induction of ovulation. The best corrected visual acuity was 7/10 (20/32) in the left eye and 10/10 (20/20) in the right eye. Fundus examination of the left eye revealed flame-shaped haemorrhages, whitening of the retina along the distribution of cilioretinal artery and tortuous retinal veins. Fluorescein angiography confirmed the combination of a non-ischaemic CRVO with CLRAO. The patient was treated with a 2 h session of hyperbaric oxygen at 253 kPa (2.5 atmospheres absolute) once daily for a total of 30 sessions. Best corrected visual acuity improved to 10/10 (20/20) in the left eye. Conclusions: CRVO and CLRAO are both occlusive disorders. HBOT is a safe low-cost treatment modality that can be beneficial in some ocular pathologies. It can maintain oxygenation of the retina through the choroidal blood supply, decrease oedema and preserve compromised tissue adjacent to the ischaemic area.