Efficacy of Hyperbaric Oxygen Therapy on Central Corneal Thickness, Intraocular Pressure, and Nerve Fiber Layer in Patients with Type 2 Diabetes: A Prospective Cohort Study

Purpose: To evaluate the effect of hyperbaric oxygen therapy (HBOT) on central corneal thickness (CCT), intraocular pressure(IOP), and the retinal nerve fiber layer (RNFL) thickness in patients with type 2 diabetes mellitus. Methods: This prospective non-randomized cohort study consisted of type 2 diabetes mellitus patients who received 30sessions of HBOT for diabetic foot ulcer. The CCT, IOP, and RNFL measured at baseline, after the 10th session of HBOT, afterthe 20th session of HBOT, after the 30th session of HBOT, and after the 3 months of the last session of HBOT. We gained thesuperior-nasal, superior-temporal, inferior-nasal, inferior-temporal, nasal and temporal quadrant RNFL values with a spectral-domain optical coharence tomography. Results: Forty-six eyes of 46 patients included in the study. During the study period, a statistically significant increase in meanIOP values compared to baseline was observed (p < 0.001). We found no significant changes at CCT and all quadrants of RNFLvalues during HBOT and after 3 months of the treatment (p > 0.05). During the study period, the IOP levels increased over21 mmHg (between 22 and 28 mmHg) in seven eyes (15.2%). The mean hemoglobin A1c values of these patients with IOP>21 mmHg were 8.2 ± 0.9 mg/dL, and there was significant differences compared with those of patients with IOP values ≤21mmHg (7.4 ± 2.8 mg/dL) (p = 0.001). Conclusions: HBOT increase IOP in type 2 diabetic patients especially in ones with impaired blood glucose regulation. However,it does not cause any changes in CCT and RNFL. As diabetic retinopathy and diabetic foot ulcer are in common pathologies,thus this brief report concludes a need for further studies with longer follow-up periods to explore the potential interactionof HBOT on CCT, IOP, and RNFL.