From the Guidelines
Hyperbaric oxygen therapy (HBOT) is not currently recommended as a standard treatment for macular degeneration. The most recent and highest quality study on this topic is not available, but based on the provided evidence, there is insufficient scientific evidence to support the routine use of HBOT for macular degeneration 1. HBOT involves breathing pure oxygen in a pressurized chamber, which increases oxygen concentration in the blood and potentially improves oxygen delivery to tissues.
For macular degeneration, conventional treatments remain the standard of care, including:
- anti-VEGF injections for wet AMD
- AREDS2 vitamin supplements for dry AMD
- lifestyle modifications such as smoking cessation, regular exercise, and a diet rich in leafy greens and fish. The theoretical basis for HBOT in macular degeneration relates to improving oxygen delivery to the retina, potentially reducing oxidative stress and inflammation, and possibly stimulating stem cell activity. However, HBOT carries risks including ear and sinus pain, temporary nearsightedness, claustrophobia, and rarely oxygen toxicity or lung damage 1.
Patients interested in HBOT should discuss this option with their ophthalmologist and consider it only as part of a clinical trial or as a complementary approach alongside proven treatments. It is essential to prioritize conventional treatments that have been proven to improve morbidity, mortality, and quality of life for patients with macular degeneration. The use of HBOT should be approached with caution, and patients should be aware of the potential risks and benefits before making a decision.
From the Research
Hyperbaric Chamber for Macular Degeneration
- The use of hyperbaric oxygen therapy for macular degeneration has been explored in a pilot study 2, which found that hyperbaric oxygen therapy may be a safe and tolerable treatment option for patients with active choroidal neovascularization, potentially delaying its progression.
- The study involved 7 patients with an average age of 73, who underwent 10 daily sessions of hyperbaric oxygen therapy at 2 atmospheres absolute for 120 minutes each session.
- After the sessions, 5 patients showed anatomical improvement, 1 patient maintained anatomical aspect, and 1 patient showed anatomical worsening.
- However, the majority of the evidence on treating macular degeneration focuses on anti-vascular endothelial growth factor (anti-VEGF) therapies, which have been shown to be safe and effective in maintaining visual acuity and improving vision in some cases 3, 4, 5, 6.
- Anti-VEGF agents, such as pegaptanib, ranibizumab, and bevacizumab, work by blocking the growth of abnormal blood vessels in the eye, which can cause vision loss in patients with neovascular age-related macular degeneration.
- The evidence suggests that intravitreal injection of anti-VEGF agents is a safe and effective treatment for neovascular age-related macular degeneration, with improvements in visual acuity and morphologic outcomes compared to control treatments 4, 6.
- However, there is limited evidence on the use of hyperbaric oxygen therapy for macular degeneration, and further research is needed to fully understand its potential benefits and risks.