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2012-02-28T01:23:21Z

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'''Patients with retinitis pigmentosa who received hyperbaric oxygen did not show deterioration in electroretinographic response (ERG), and a small proportion improved.''' 

'''Clinical Bottom Line:''' 
1. HBO administration prevented deterioration in electroretinographic responses over 3 years. 
2. HBO administration increased mean electroretinographic responses over the 3 years of the study, but only a small proportion of subjects improved.
'''Citation:''' 
1. Vingolo E, Pelaia, Forte R. Rocco M, Giusti C, Rispole E. Does hyperbaric oxygen (HBO) delivery rescue retinal photoreceptors in retinitis pigmentosa? Documenta Opthalmologica 97: 33-39, 1999 

'''Three-part Clinical Question:''' For patients with retinitis pigmentosa, does hyperbaric oxygen therapy (when compared to no treatment) modify electroretinographic responses? 
'''Search Terms:''' hyperbaric oxygenation, retinitis pigmentosa 

'''The Study:''' 
Non-blinded randomised controlled trial with intention-to-treat. 
'''The Study Patients''': A diagnosis of retinitis pigmentosa with clearly identified inheritance. Specific criteria and electroretinographic (ERG) data were utilised to aid diagnosis. 
'''Control group''' (N = 24; 24 analysed): No specific treatment. 
'''Experimental group''' (N = 24; 24 analysed): Hyperbaric oxygen therapy (Schedule: 100% O2 at 2.2 ATA for 90 mins). 1st month: 5 treatments per week. Next 11 months: one week of treatments per month. Year 2 and 3: one week of treatments every 3 months. 

'''The Evidence:''' 

{|
| '''Outcome''' || '''Time to Outcome''' || '''Control group''' || '''Hyperbaric group''' || '''Relative risk reduction''' || '''ARR''' || '''NNT''' 
|-
| '''ERG improved''' || 3 years || 0 || .11 || INF || -0.11 || 9 
|-
| '''95% CI:''' || || || || || -0.24 to 0.02 || NNT ''' 4 to INF NNH = 66 to INF 
|-
| '''ERG deteriorated''' || 3 years || 0.62 || 0 || 100% || 0.62 || 2 
|-
| '''95% CI:''' || || || || || 0.43 to 0.81 || 1 to 2 
|-
|}

{|
| '''Measure''' || '''Control Group Mean''' || '''SD''' || '''HBO Group Mean''' || '''SD''' || '''Difference''' || '''95% CI''' 
|-
| '''ERG b-wave amplitude in microV at 1 year''' || 5.04 || 3.07 || 8.46 || 5.71 || 3.42 || 0.76 to 6.09 
|-
| '''ERG b-wave amplitude in microV at 2 years''' || 3.46 || 2.77 || 10.7 || 7.6 || 7.24 || 3.92 to 10.57 
|-
| '''ERG b-wave microV at 3 years''' || 2.97 || 3.61 || 14.4 || 11.7 || 11.43 || 16.46 to-6.40 
|-
|}

'''Comments:''' 
1. Small study with highly defined patient population. Severely affected individuals were excluded. 
2. This study suggests that treatment with HBO will prevent ERG deterioration in 1 out every 2 patients over 3 years. 
3. Visual acuity was not estimated in this study and ERG response may not equate with important changes in visual acuity. 

'''Appraised by:''' Juliette Leverment and Mike Bennett 
Prince of Wales Hospital, Sydney; Friday, 6 December 2002 
Email: [[mailto:jullietteleverment@hotmail.com | jullietteleverment@hotmail.com]] 
'''Kill or Update By:''' March 2014 

[[File:http://www.hboevidence.com/_themes/copy-of-sumi-painting/sumhorsa.gif|center|external]]

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Vingolo - Revision history

Gordoben: Imported from Wikispaces