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Proliferative retinopathy during hyperbaric oxygen treatment.
Viet Tran1,2, David Smart1,3
1Hyperbaric Medicine Unit, Royal Hobart Hospital, Tasmania, Australia.
Diving and Hyperbaric Medicine
|September 5, 2017
Summary
Hyperbaric oxygen treatment may accelerate proliferative diabetic retinopathy in patients with diabetes. This case highlights the potential risks of HBOT for diabetic eye complications, necessitating careful monitoring.
Area of Science:
- Ophthalmology
- Diabetology
- Hyperbaric Medicine
Background:
- A patient with type 2 diabetes and a history of proliferative diabetic retinopathy (PDR) underwent hyperbaric oxygen treatment (HBOT) for refractory plantar ulcers.
- The patient had previously undergone cataract surgery and had non-proliferative diabetic retinopathy (NPDR) prior to HBOT.
Observation:
- During HBOT, the patient developed pre-retinal hemorrhage in the left eye, progressing to proliferative changes in both eyes.
- These changes occurred despite previous treatment for PDR and were temporally related to HBOT sessions.
Findings:
- The patient's NPDR rapidly evolved into PDR during HBOT, a progression not previously documented in similar cases post-HBOT.
- While other factors like cataract surgery were considered, the rapid onset of PDR during HBOT suggests a potential link.
Implications:
- This case raises concerns about the potential adverse effects of HBOT on retinal vasculature in diabetic patients.
- It underscores the importance of vigilant ophthalmic screening and monitoring for diabetic patients undergoing HBOT, especially those with pre-existing retinopathy.
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