Çevik MÖ, Bagli BS, Çevik SG, et al.
Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc. Date of publication 2020 Jan 1;volume 47(1):65-73.
1. Undersea Hyperb Med. 2020 First Quarter;47(1):65-73. doi:
10.22462/01.03.2020.8.
Hyperbaric oxygen treatment results in a group of Turkish central retinal artery
occlusion patients with a combined presence of thrombophilic mutations.
Çevik MÖ(1), Bagli BS(2), Çevik SG(1).
Author information:
(1)Adiyaman University Faculty of Medicine Department of Medical Genetics,
Adiyaman, Turkey.
(2)Bursa Yüksek Ihtisas Training Hospital Dept. of Hyperbaric Medicine, Bursa,
Turkey.
BACKGROUND: Central retinal artery occlusion (CRAO) is a rare ocular-ischemic
syndrome causing irreversible blindness. Its pathophysiology has not been
clarified, and no targeted therapies are available yet. Hyperbaric oxygen (HBO2)
therapy is already an approved therapy for CRAO and has been shown to improve
the visual acuity of CRAO patients safely. However, further clinical data are
required to classify HBO2 therapy as a type-I general agreement for CRAO.
MATERIALS AND METHODS: Eleven patients with non-arteritic CRAO were enrolled.
Patient demographics, medical history, detailed eye examinations, HBO2 therapy
results, pre-/post HBO2 therapy visual acuity measurements and genotypes for
common thrombophilic mutations (Factor V G1691A Leiden, Factor II G20210A, MTHFR
A1298C, MTHFR C677T, and PAI-1-675 4G/5G) were obtained.
RESULT: Six patients (54%) responded to HBO2 therapy compared to five
non-responders (46%). Patients admitted before 12 hours responded well to HBO2
therapy. No systemic diseases nor advanced age were statistically correlated to
CRAO. A combination of mutations rather than single mutations for each patient
could be seen as responsible for CRAO. No Factor V G1691A Leiden mutations and
only one FII G20210A mutation were observed. Eight patients (72%) had MTHFR 677T
allele, five patients (45%) had MTHFR 1298C allele, and 10 patients (91%) had
the PAI-1-675 4G allele.
CONCLUSION: Not a single mutation but a combination of mutations and other
unknown factors probably lead to CRAO, and if intervention is timely, HBO2
therapy offers improvement in visual acuity safely.
Copyright© Undersea and Hyperbaric Medical Society.
DOI: 10.22462/01.03.2020.8
PMID: 32176948 [Indexed for MEDLINE]
Conflict of interest statement: The authors of this paper declare no conflicts
of interest exist with this submission.
