Oxygen therapy and intraocular oxygenation.

When delivered to the corneal surface of rabbits or monkeys, 100% oxygen can significantly increase the pO2 in the aqueous humor. Under hyperbaric conditions (two atmospheres), an observed rise in the aqueous pO2 in rabbits breathing room air can be increased further by exposing the rabbit cornea to 100% oxygen. The high oxygen levels under hyperbaric conditions are mediated by intravascular and transcorneal delivery of oxygen. The increase in the pO2 levels in the aqueous can prevent sickling of intracameral human erythrocytes containing sickle hemoglobin. Thus, oxygen therapy transcorneally or systemically could potentially be used to treat a sickle cell hyphema. The exposure of rabbit eyes to 100% oxygen at the corneal surface is followed by autoregulation (constriction) of the iris vasculature. We could demonstrate no constriction in the eyes of two normal human volunteers or of four patients with chronic stable rubeosis iridis. Preretinal vitreous pO2 levels can be significantly raised by exposing monkeys to hyperbaric 100% oxygen. This procedure may be of value in treating acute, reversible ischemic inner retinal diseases. Transcorneal or vascular delivery of oxygen to the eye under normobaric or hyperbaric conditions may be effective in treating ischemic diseases of the anterior segment, such as anterior segment necrosis or rubeosis iridis, or ischemic inner retinal diseases.