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2018-05-04T02:17:18Z

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==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.
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|}
**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'''
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| '''Visual acuity >80% of starting value''' || 5 years || 0.70 || 0.88 || 24% || 0.2 || 6
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|^ |||||| 95% CIs: || 4% to 45% || 0.03 to 0.31 || 3 to 35
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| '''Visual acuity >80% of starting value ''' || 10 years || 0.4 || 0.63 || 58% || 0.23 || 4
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|^ |||||| 95% CIs: || 15% to 102% || 0.06 to .410 || 2 to 17 
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|}

**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

[[File:sumhorsa.gif|center|sumhorsa.gif]]

'''[[Ophthalmology | BACK]]'''

Vingolo2 - Revision history

Gordoben: Imported from Wikispaces