Hyperbaric Oxygen Therapy Combined With Intravitreal Aflibercept for Combined Retinal Vascular Occlusion in a Young Patient

Purpose: To report the outcomes of combined retinal vascular occlusion involving central retinal vein occlusion and cilioretinal artery occlusion in a young patient treated with intravitreal (IVT) antivascular endothelial growth factor (anti-VEGF) injections and hyperbaric oxygen therapy. Methods: A single case was reviewed. Results: A 28-year-old man presented with sudden visual loss in the left eye. Initial visual acuity (VA) was 20/400 at presentation to the emergency department, which improved to 20/20 after intravenous mannitol was administered the same day. The next day, VA worsened to counting fingers. Fundus examination and optical coherence tomography revealed cilioretinal pallor and macular edema. The patient was treated with IVT anti-VEGF injection and hyperbaric oxygen therapy. After 3 aflibercept injections and 39 hyperbaric oxygen therapy sessions, VA improved to 20/20. Microperimetry showed regression of the scotoma, which remained stable at the 1-year follow-up. The etiology of combined retinal vascular occlusion remained undetermined. Conclusions: A personalized treatment approach combining anti-VEGF therapy and hyperbaric oxygen therapy led to favorable anatomic and functional recovery in a young patient with combined retinal vascular occlusion. Further studies are needed to validate the effectiveness of this combined therapeutic approach.