Hyperbaric Oxygen Therapy Combined with Immunosuppression for Acute Macular Neuroretinopathy in Systemic Lupus Erythematosus

Ocul Immunol Inflamm. 2023 Feb;31(2):355-361. doi: 10.1080/09273948.2022.2029497. Epub 2022 Feb 3.

Abstract

Purpose: To describe the use of hyperbaric oxygen therapy (HBOT) in conjunction with immunosuppression for acute macular neuroretinopathy (AMN) in systemic lupus erythematosus (SLE).

Methods: Two known cases of SLE presented to us with blurred vision and paracentral scotomas due to AMN. Both cases reported worsening of their conditions despite the initiation of high-dose steroid therapy. HBOT was added on as a treatment modality to address vaso-occlusive ischemic injury.

Results: Both patients underwent a total of twelve cycles of HBOT. Functional and anatomical improvements were noted immediately after the initiation of therapy and were maintained over more than one year of follow-up. No significant retinal thinning was noted on optical coherence tomography on disease resolution, as has been noted previously. Visual field scotoma showed a complete resolution.

Conclusion: Our cases suggest that HBOT may have a role in aiding functional and anatomical recovery in AMN associated with SLE.

Keywords: Acute macular neuroretinopathy; Hyperbaric oxygen therapy; Immunosuppression; Optical coherence tomography; Systemic lupus erythematosus; Visual fields.

MeSH terms

  • Acute Disease
  • Humans
  • Hyperbaric Oxygenation*
  • Immunosuppression Therapy
  • Lupus Erythematosus, Systemic* / complications
  • Lupus Erythematosus, Systemic* / therapy
  • Macula Lutea*
  • Retinal Diseases* / diagnosis
  • Retinal Diseases* / etiology
  • Retinal Diseases* / therapy
  • Scotoma / diagnosis
  • Scotoma / etiology
  • Scotoma / therapy
  • Tomography, Optical Coherence / methods
  • White Dot Syndromes* / complications