Li Charles Q, Gerson Samuel, Snyder Brian
Undersea Hyperb Med. 2014 Jan-Feb;41(1):59-63.
Hyperbaric oxygen (HBO2) therapy has been utilized in conjunction with systemic corticosteroid administration for treating radiation-induced optic neuropathy (RON) with varying success. We present the case of a 78-year-old female with RON who received two courses of HBO2 (without corticosteroids) and also pre- and post-treatment magnetic resonance imaging (MRI) of her brain. Her visual acuity subjectively and functionally improved throughout her first course of 30 treatments, including regaining the ability to ambulate independently, but subsequently deteriorated following completion. A second course of 40 additional treatments was prescribed; the patient's visual symptoms subjectively improved once more, followed again with subsequent decline after treatment. Post-treatment MRI also showed resolution of previously visible optic nerve contrast enhancement. This patient represents the 27th reported case of RON treated with HBO2 and the first reported case of radiologic and transient symptomatic improvement without concomitant steroid use. Our case adds additional evidence to the limited anecdotal data supporting MRI correlation with RON symptoms and HBO2 in RON treatment as well.
高压氧（HBO₂）疗法已与全身使用皮质类固醇联合用于治疗放射性视神经病变（RON），但效果各异。我们报告一例78岁患有RON的女性病例，该患者接受了两个疗程的HBO₂治疗（未使用皮质类固醇），并且在治疗前后均进行了脑部磁共振成像（MRI）检查。在她的第一个包含30次治疗的疗程中，其视力在主观和功能上均有改善，包括重新获得独立行走的能力，但在疗程结束后视力随后恶化。于是又开出了第二个包含40次额外治疗的疗程；患者的视觉症状再次主观上有所改善，但治疗后又再次下降。治疗后的MRI还显示先前可见的视神经对比增强消失。该患者是第27例报道的接受HBO₂治疗的RON病例，也是首例在未使用类固醇的情况下出现影像学和短暂症状改善的报道病例。我们的病例为有限的轶事性数据增添了更多证据，这些数据支持MRI与RON症状的相关性以及HBO₂在RON治疗中的作用。
