Vingolo2
Hyperbaric oxygen maintained visual acuity in retinitis pigmentosa
| Clinical bottom line: 1. HBOT for 10 years maintained visual acuity compared to Vitamin A supplementation alone. |
- Citation/s:
1. Vingolo EM, Rocco M, Grenga PL, Salvatore S, Pelaia P. Slowing the degenerative process, long lasting effect of hyperbaric oxygen therapy in retinitis pigmentosa. Graefe’s Archive for Experimental Ophthalmology 2008;246(1):93-98.
Lead author's name and email: Enzo Vingolo (contact S. Salvatore email serena.sal@hotmail.it) Three-part Clinical Question: In patients with retinitis pigmentosa, does giving hyperbaric oxygen result in better retention of vision compared to simple Vitamin A supplementation
Search Terms: Retinitis pigmentosa, visual acuity testing, Vitamin A The Study: Non-blinded randomised controlled trial with intention-to-treat.
The Study Patients: Patients with retinitis pigmentosa and progressive visual acuity deterioration with poor night vision.
Control group (N = 60 ; 44 analysed): Vitamin A supplementation.
Experimental group (N = 60 ; 44 analysed): HBOT at 2.2 ATA for 90 min for three sessions 5 days a week for 1 month, then 5 days consecutively a month for the following 11 months and 5 days consecutively every 3 months for the next 9 years.
- The Evidence:
| Outcome | Time to Outcome | Vit A group rate | HBOT group rate | Relative risk reduction | Absolute risk reduction | NNT |
| Visual acuity >80% of starting value | 5 years | 0.70 | 0.88 | 24% | 0.2 | 6 |
| ^ | 95% CIs: | 4% to 45% | 0.03 to 0.31 | 3 to 35 | ||
| Visual acuity >80% of starting value | 10 years | 0.4 | 0.63 | 58% | 0.23 | 4 |
| ^ | 95% CIs: | 15% to 102% | 0.06 to .410 | 2 to 17 |
- Comments:
1) Subjects not blinded and as the disease is heterogeneous in genetic progression, this was not taken into account
2)Very non-standard HBOT regimen
3) Multiple other tests also showed a reduced loss of retinal function with the HBOT group but clinical significance difficult to interpret Appraised by: Dr Glen Hawkins Department of Diving and Hyperbaric Medicine Prince of Wales Hospital Barker St, Randwick, NSW 2031, Australia; 20 April 2018
Email: glen.hawkins@unsw.edu.au
Kill or Update By: 20 April 2021
