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Abstract
Background: Occlusive vasculitis affecting the optic nerve or chiasm is an infrequent delayed complication of radiation treatment. Hyperbaric oxygen (HBO) has been used to treat such a complication, but its efficacy is controversial. Objectives: To report the outcome of radiation-induced optic neuropathy (RON) treated with HBO, compared against natural course of untreated RON and against other forms of therapy. Methods: We report five patients with RON, four treated with HBO. Cases accrued in the world literature are analyzed for outcome and possible confounding factors. Results: From our treated series, two patients recovered significant visual function, one patient's vision remained unchanged, one patient continued to deteriorate. Among 120 similar cases, no instances of spontaneous improvement of vision are documented, nor is recovery with other forms of therapy. Conclusion: Our data suggest that HBO at a minimum pressure of 2.4 atmospheres may be effective in reversing the visual loss induced by radiation damage to the optic nerves and chiasm.