Sickle cell disease is a hereditary blood disorder characterized by red blood cells that assume an abnormal, rigid, sickle shape. Sickling decreases the blood cells' flexibility and results in a risk of various life-threatening complications including vaso-occlusion. The sickle syndromes have the highest incidence in black Africans and African-Americans, but are also being found in people from Mediterranean countries [
4]. Almost any organ can be affected by this vasoocclusive phenomenon. In retina, the sickled red blood cells obstruct the retinal vessels leading to reduced blood flow and retinal vascular occlusion. There are only a few published reports of retinal artery occlusion associated with SCD [
5‐
7]. Treatment experience of CRAO with SCD is even more limited. In these cases, exchange transfusion should be considered first in order to restore vascular perfusion [
6]. Hydroxyurea may be recommended for prophylactic treatment to prevent systemic crises [
5]. The alternatives for the treatment of CRAO in SCD consist of pharmacological and mechanical reduction of ocular pressure, HBO therapy, ocular massage, and direct thrombolysis, however their benefits are not well proven [
6]. HBO therapy was reported to be useful in the treatment of CRAO [
8‐
11]. This therapy shows its effect by increasing tissue oxygenation. Also, in our case reperfusion of the retina was observed following HBO therapy. This suggests that increased arterial pO2 may reverse sickling of erythrocytes in the microcirculation of the retina and optic nerve. Further, the elevated level of pO2 in tissue may diminish the risk of tissue ischemia and retinal infarction [
12]. The limitation of this case report is that we cannot be certain of how much of the improvement in visual acuity may be attributed to HBO therapy or to the exchange therapy. A recent study of Menzel-Severing
et al. reported that in the treatment of cases with CRAO, combined HBO and hemodilution treatment achieved more improvement of visual acuity compared to hemodilution alone [
13].
In this case we report the benefit of HBO therapy in addition to systemic treatment in a young adult with SCD and CRAO. To the best of our knowledge this is the first case in the current literature to report the use of HBO in CRAO in a case with SCD. Our case suggests that even in cases with SCD, HBO therapy may be a valuable treatment alternative, in addition to the systemic treatment in CRAO.