title: Hyperbaric oxygen therapy for choroidal neovascularization: a pilot study.
abstract: BACKGROUND
  Choroidal neovascularization (CNV) is one of the leading causes of blindness worldwide and affects patients with wet age-related macular degeneration (AMD). Its natural course may lead to impaired central vision and macular fibrosis. Even VEGF blockade, currently the best available treatments for CNV, may fail to improve vision. Hyperbaric oxygen (HBO2) therapy may be an alternative or ancillary treatment for CNV.
  
  
  METHODS
  AMD patients with active CNV underwent 10 daily sessions of HBO2 at 2 atmospheres absolute (atm abs) for 120 minutes each session. After the end of the sessions, patients with clinical or tomographical signs of CNV activity underwent standard anti-VEGF treatment.
  
  
  RESULTS
  Seven patients (average age 73) underwent 10 daily 120-minute sessions of HBO2 at 2 atm abs. After the sessions, five patients underwent intravitreal injection of bevacizumab. Average follow-up was 150 days. Average CNV area at baseline was 14.42 mm2; average CNV greatest linear diameter at baseline was 4.56 mm. Statistical analysis of variance (ANOVA) was performed for central retinal thickness and volume mean percentage changes post-treatment. At the end of follow up, five patients showed anatomical improvement, one patient maintained anatomical aspect and one patient showed anatomical worsening.
  
  
  CONCLUSIONS
  HBO2 may be a safe and tolerable treatment option for patients with active CNV, potentially delaying its progression, as monotherapy or in combination with intravitreal bevacizumab.
authors.forename: Fernando K
authors.initials: FK
authors.lastname: Malerbi
authors.forename: Eduardo A
authors.initials: EA
authors.lastname: Novais
authors.lastname: Emmerson Badaró
authors.forename: Pedro Paulo de O
authors.initials: PP
authors.lastname: Bonomo
authors.forename: Adriano J
authors.initials: AJ
authors.lastname: Pereira
authors.forename: Claudio L
authors.initials: CL
authors.lastname: Lottenberg
authors.forename: André
authors.initials: A
authors.lastname: Maia
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000068258:Bevacizumab; D020256:Choroidal Neovascularization / Q000209:etiology / Q000628:therapy*; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000009:adverse effects / Q000379:methods*; D058449:Intravitreal Injections; D008268:Macular Degeneration / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab