Location
Suwanee, GA
Start Date
17-4-2026 12:00 PM
End Date
17-4-2026 1:00 PM
Description
Case Description/Objective: A 58-year-old African American man with a history of left skullbase meningioma presented to the emergency department with acute bilateral vision loss on April 16. He completed external beam radiation therapy in August 2024, receiving a total dose of 50.4 Gy over one month. MRI of the brain and orbits with and without contrast supported the diagnosis of optic neuritis, most consistent with radiation-induced etiology. He was treated with intravenous methylprednisolone for five days and discharged on oral dexamethasone, pentoxifylline, and vitamin E, with instructions to initiate Hyperbaric Oxygen Therapy (HBOT) as soon as possible at Emory University Hospital Midtown.
Interventions/Methods: The patient began HBOT approximately 1.5 weeks after hospital discharge in early May. He completed 40 HBOT sessions by the end of July. Treatments were administered at 2.4 ATA for 90 minutes, including two 10-minute air breaks per session.
Outcome/Results: The patient was followed closely by neuro-ophthalmology throughout HBOT and steroid therapy. Following completion of all 40 HBOT sessions, the patient reported grossly stable vision, with mild fluctuations related to lighting conditions that intermittently improved. Patient was educated by neuro-ophthalmology that HBOT and steroid treatment have stabilized his vision and that no further worsening of his vision is a good outcome. Patient was instructed to follow up with optometry for vision aids and visual rehabilitation to optimize his vision.
Discussion: Radiation-induced optic neuropathy is a delayed complication of radiation therapy involving the brain, orbit, or sinuses, typically occurring 6–36 months post-radiation. The pathophysiology is thought to involve radiation-induced microvascular endothelial damage, leading to vessel fibrosis, hypoxia, and ischemic injury to the optic nerve and chiasm. HBOT may benefit patients with RION by enhancing tissue oxygenation, improving blood flow, and promoting angiogenesis in hypovascular irradiated tissues, thereby slowing disease progression. Existing literature suggests that earlier initiation of HBOT after symptom onset may improve the likelihood of visual stabilization. This case supports the potential role of HBOT as an adjunctive therapy in preventing further vision loss in RION.
Embargo Period
6-2-2026
Included in
A Case of Radiation-Induced Optic Neuritis (RION) Managed with Hyperbaric Oxygen Therapy
Suwanee, GA
Case Description/Objective: A 58-year-old African American man with a history of left skullbase meningioma presented to the emergency department with acute bilateral vision loss on April 16. He completed external beam radiation therapy in August 2024, receiving a total dose of 50.4 Gy over one month. MRI of the brain and orbits with and without contrast supported the diagnosis of optic neuritis, most consistent with radiation-induced etiology. He was treated with intravenous methylprednisolone for five days and discharged on oral dexamethasone, pentoxifylline, and vitamin E, with instructions to initiate Hyperbaric Oxygen Therapy (HBOT) as soon as possible at Emory University Hospital Midtown.
Interventions/Methods: The patient began HBOT approximately 1.5 weeks after hospital discharge in early May. He completed 40 HBOT sessions by the end of July. Treatments were administered at 2.4 ATA for 90 minutes, including two 10-minute air breaks per session.
Outcome/Results: The patient was followed closely by neuro-ophthalmology throughout HBOT and steroid therapy. Following completion of all 40 HBOT sessions, the patient reported grossly stable vision, with mild fluctuations related to lighting conditions that intermittently improved. Patient was educated by neuro-ophthalmology that HBOT and steroid treatment have stabilized his vision and that no further worsening of his vision is a good outcome. Patient was instructed to follow up with optometry for vision aids and visual rehabilitation to optimize his vision.
Discussion: Radiation-induced optic neuropathy is a delayed complication of radiation therapy involving the brain, orbit, or sinuses, typically occurring 6–36 months post-radiation. The pathophysiology is thought to involve radiation-induced microvascular endothelial damage, leading to vessel fibrosis, hypoxia, and ischemic injury to the optic nerve and chiasm. HBOT may benefit patients with RION by enhancing tissue oxygenation, improving blood flow, and promoting angiogenesis in hypovascular irradiated tissues, thereby slowing disease progression. Existing literature suggests that earlier initiation of HBOT after symptom onset may improve the likelihood of visual stabilization. This case supports the potential role of HBOT as an adjunctive therapy in preventing further vision loss in RION.