Description

Çevik SG, Ozbek M, Simsek M, Taşkın G, Orak MS, Artunay O. Time-Dependent Efficacy of

Hyperbaric Oxygen Therapy in Central Retinal Artery Occlusion. Undersea Hyperb Med. 2026 Third

Quarter; 53(3):471-480.

Introduction: To determine the effect of the timing of hyperbaric oxygen (HBO2) treatment on functional

and structural outcomes in central retinal artery occlusion (CRAO).

Methods: This single‑center retrospective cohort study analyzed 101 eyes with CRAO treated with HBO2.

Eyes were stratified by symptom‑to‑treatment interval: ≤12 hours (Group 1), 12–24 hours (Group 2), 24–

36 hours (Group 3), and >36 hours (Group 4). Best‑corrected visual acuity (BCVA-logMAR), central macular

thickness (CMT), and inner retinal hyperreflective band thickness (IRHBT) were recorded at presentation,

week 1, and month 6.

Results: Presentation BCVA was 2.16 ± 1.04, improving to 1.77 ± 1.02 at month 6 (p

=

0.03). The mean

BCVA gain was greatest in Group 1: −0.85 ± 0.96, and declined markedly with delayed treatment initiation

(Group 2: −0.48 ± 1.38; Group 3: −0.10 ± 1.50; Group 4: −0.08 ± 1.77). In Group 1, the mean BCVA

improved significantly from 2.04 ± 0.78 logMAR at presentation to 1.19 ± 0.56 logMAR at the 6-month

follow-up (p = 0.02). Early treatment was also associated with more pronounced reductions in CMT

and IRHBT, whereas anatomical changes were negligible when therapy was initiated beyond 24 hours.

Baseline CMT and IRHBT showed modest but significant correlations with final BCVA (r

=

0.37, p

=

0.03 ,

and r=0.34, p=0.04, respectively).

Discussion: HBO2 provides a significant, time-sensitive benefit for CRAO; initiating treatment within

12–24 hours maximizes recovery and retinal remodeling, validating HBO2 as a critical adjunct and

necessitating rapid triage in ophthalmic emergencies.

Keywords: central retinal artery occlusion; hyperbaric oxygen treatment; inner hyperreflective band;

optical coherence tomography