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Case Reports
. 2010 May 14:4:433-6.
doi: 10.2147/opth.s9803.

Hyperbaric oxygen therapy for the treatment of radiation-induced macular ischemia

Shamim A Haji  1 , Ronald Ep Frenkel
Affiliations
Case Reports

Hyperbaric oxygen therapy for the treatment of radiation-induced macular ischemia

Shamim A Haji et al. Clin Ophthalmol. .

Abstract

Purpose: To report a case of radiation-induced macular ischemia where vision and macular perfusion improved after hyperbaric oxygen (HBO) therapy.

Methods: A 62-year-old male patient developed radiation-induced macular ischemia after he was treated with radiation for brain glioma. The patient presented with best spectacle-corrected visual acuity (BSCVA) acuity of 20/400 in his right eye. Optical coherence tomography (OCT) showed central macular thickness of 468 mum. The patient received focal laser, intravitreal triamcinolone, and HBO therapy.

Results: The patient's vision improved from 20/400 to 20/100 after focal laser and intravitreal triamcinolone. His central macular thickness improved from 468 mum to 132 mum. After receiving HBO therapy, his VA improved to 20/50 and fluorescein angiography showed improvement in macular perfusion.

Conclusion: HBO therapy improves macular perfusion in patients with radiation-induced macular ischemia.

Keywords: hyperbaric oxygen therapy; macular ischemia; macular perfusion; visual acuity.

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Figures

Figure 1
Figure 1
(Left) Optical coherence tomography retinal color map (top) and thickness map (bottom) showing central macular thickness of 468 μm before any treatment. (Right) Horizontal line scan of macula showing intraretinal and subretinal fluid with large serous retinal detachment. At presentation, best spectacle-corrected visual acuity was 20/400.
Figure 2
Figure 2
(Left) OCT color retinal map (top) and thickness map (bottom) showing regression of central macular thickness to 132 μm. (Right) Horizontal line scan showing no intraretinal fluid or serous retinal detachment after treatment with focal laser and intravitreal injection of triamcinolone. BSCVA improved from 20/400 to 20/100.
Figure 3
Figure 3
Late phase fluorescein angiography, (Left) showing collaterals and ischemia of the macula before HBO therapy. (Right) showing improvement of collaterals and ischemia after HBO therapy. BSCVA improved from 20/100 to 20/50 after the HBO therapy. Abbreviations: BSCVA, best spectacle-corrected visual acuity; HBO, hyperbaric oxygen.
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