Au SCL, Chong SSY. Prognostic factors for acute central retinal artery occlusion treated with hyperbaric oxygen: The Hong Kong study report number five. World J Methodol 2025; 15(2): 96777 [DOI: 10.5662/wjm.v15.i2.96777]
Corresponding Author of This Article
Sunny Chi Lik Au, MBChB, Chief Doctor, Surgeon, Department of Ophthalmology, Tung Wah Eastern Hospital, Lo Ka Chow Memorial Ophthalmic Centre, No. 19 Eastern Hospital Road, Causeway Bay, Hong Kong 999077, China. kilihcua@gmail.com
Research Domain of This Article
Ophthalmology
Article-Type of This Article
Prospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Methodol. Jun 20, 2025; 15(2): 96777 Published online Jun 20, 2025. doi: 10.5662/wjm.v15.i2.96777
Prognostic factors for acute central retinal artery occlusion treated with hyperbaric oxygen: The Hong Kong study report number five
Sunny Chi Lik Au, Steffi Shing Yee Chong
Sunny Chi Lik Au, Steffi Shing Yee Chong, Department of Ophthalmology, Tung Wah Eastern Hospital, Hong Kong 999077, China
Sunny Chi Lik Au, Steffi Shing Yee Chong, Department of Ophthalmology, Pamela Youde Nethersole Eastern Hospital, Hong Kong 999077, China
Author contributions: Au SCL designed the research study, performed the research, and wrote the manuscript; Chong SSY acquired and analyzed the data; all authors have read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Hong Kong East Cluster Research Ethics Committee (Approval No. HKECREC-2020-116).
Clinical trial registration statement: This study is registered at https://harec.ha.org.hk/Portal. The registration identification number is HKEC-2020-0130.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: Neither authors received fees for serving as a speaker. Neither authors received research funding. Both authors are employees of Hong Kong East Cluster Ophthalmic Service Unit of Hong Kong Hospital Authority.
Data sharing statement: Dataset is available from the corresponding author at kilihcua@gmail.com. Participants consent was not obtained because the presented data are anonymized and risk of identification is low.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sunny Chi Lik Au, MBChB, Chief Doctor, Surgeon, Department of Ophthalmology, Tung Wah Eastern Hospital, Lo Ka Chow Memorial Ophthalmic Centre, No. 19 Eastern Hospital Road, Causeway Bay, Hong Kong 999077, China. kilihcua@gmail.com
Received: May 15, 2024 Revised: October 11, 2024 Accepted: November 7, 2024 Published online: June 20, 2025 Processing time: 196 Days and 7.1 Hours
Abstract
BACKGROUND
Central retinal artery occlusion (CRAO) is a potentially blinding disease, and hyperbaric oxygen therapy (HBOT) is becoming increasingly popular with the support of scientific evidence. Despite the presence of various acute management measures, there is no clear evidence on the gold standard treatment for CRAO.
AIM
To identify factors and imaging parameters associated with good visual outcome, which guide ophthalmologists in the triage of CRAO patients for HBOT.
METHODS
Patients who suffered from CRAO and had a symptom onset ≤ 6 h were recruited for a course of HBOT in a tertiary hospital after failing bedside treatment. Patient demographics, onset time, CRAO eye parameters, and past medical history were prospectively collected. Visual outcomes after HBOT were also analyzed.
RESULTS
A total of 26 patients were included; the female-to-male ratio was 1:1.6, and the mean age was 67.5 years ± 13.3 years (range 44–89 years). The mean duration of follow-up and mean visual acuity (VA) improvement were 10.0 mo ± 5.3 mo and 0.48 logarithm of minimal angle of resolution (logMAR) ± 0.57 logMAR (approximately 9 letters in ETDRS) (P = 0.0001, Z = -3.67), respectively. The 1 mm zone of central macular thickness (CMT) on optical coherence tomography was not associated with VA changes (P = 0.119); however, the 1-to-3 mm circular rim of CMT was fairly associated (P = 0.02, Spearman's coefficient = 0.45). Complete retinal perfusion time during fundus fluorescein angiography (FFA) was moderately associated (P = 0.01, Spearman's coefficient = 0.58) with visual outcome.
CONCLUSION
A thinner 1-to-3 mm circular rim of CMT, but not the central 1 mm zone, is associated with better visual outcome. A shorter perfusion delay on FFA is also associated with better visual outcome.
Core Tip: Patients’ eyes with central retinal artery occlusion demonstrated a mean visual acuity improvement of 0.48 logarithm of minimal angle of resolution (logMAR) ± 0.57 logMAR (approximately 9 letters in ETDRS) after hyperbaric oxygen therapy. A thinner 1-to-3 mm zone of central macular thickness, but not the central 1 mm zone, was associated with better visual outcome. A shorter perfusion delay on fundus fluorescein angiography was also associated with better visual outcome.
