Hyperbaric oxygen and nadroparin calcium in the therapy of combined branch retinal artery and central retinal vein occlusion

Abstract

Abstract Purpose Branch retinal artery obstruction with simultaneous central retinal vein occlusion (BRAO/CRVO) is a rare condition. We describe 3 cases of BRAO/CRVO successfully treated with hyperbaric oxygen (HBO) and subcutaneous nadroparin calcium. Methods The first patient, a 42‐year‐old man, developed sudden visual loss (hand‐motion) in his left eye one day after tonsillectomy. The second patient, a 60‐year‐old man with hypercholesterolemia, complained of sudden visual loss (finger counting) in his left eye upon arising. The third patient, an apparently healthy 39‐year‐old bricklayer, noted an acute decrease in his left vision (20/70) while working. In all patients, fundus evaluation and fluorescein angiography revealed BRAO/CRVO. Results All patients were treated with HBO at 2.5 atmospheres (15‐20 sessions) and subcutaneous nadroparin calcium (200 UI/Kg/die) for 6 weeks. Two months later, there was complete resolution of the clinical signs of BRAO/CRVO and left visual acuity was 20/25 in patient 1, 20/32 in patient 2, and 20/20 in patient 3. Patient 2 had an improvement in the left visual field, but there was still a discrete cecocentral scotoma. Conclusion In these 3 patients with BRAO/CRVO, vision returned to near normal after prompt treatment with HBO and subcutaneous nadroparin calcium. We have to acknowledge that the effect of our intervention cannot be determined from 3 cases and no control. Nevertheless, a comparison between our results and those reported in similar cases seem to suggest that this therapy may be beneficial in the management of BRAO/CRVO.