Bilateral non-arteritic ischemic optic neuropathy treated with HBO2 therapy: A case report of angiographic and electrodiagnostic findings.

INTRODUCTION: Non-arteritic anterior ischemic optic neuropathy (NAION) is one of the most widespread visually disabling diseases in the middle-aged and elderly population. It typically presents as acute painless unilateral vision loss in patients over 50 years of age. The fellow eye of NAION patients is often sequentially affected. Involvement of the second eye occurs within three years in approximately 45%-50% of patients. Currently there is no generally accepted treatment for NAION but a number of medical and surgical therapies have been proposed.

REPORT OF A CASE: This is a case of non-contemporary bilateral non-arteritic anterior ischemic optic neuropathy (NAION) in a 66-year old woman treated with hyperbaric oxygen (HBO2) therapy after ineffective systemic corticosteroid therapy. Visual acuity (VA), visual evoked potentials (VEP) findings, perimetric examination results and angiographic images were recorded and analyzed before and after hyperbaric oxygen treatment.

DISCUSSION: After several months from the optic nerve vascular injury, VA, VEP values, perimetric examination results and angiographic images revealed a very important recovery. These results maintained stable during the follow-up at about nine months. HBO2 therapy has been revealed to be a safe and efficacious adjunctive therapy, even after many months after the injury. While this case is promising, double-blind randomized controlled trials will be necessary to prove the efficacy of HBO2 in the treatment of NAION.