AUTHOR=Lee Chi-Tai , Hsieh Tzu-Han , Chu Chan-Ching , Hsu Yung-Ray , Wang Jia-Horng , Wang Jia-Kang , Zhao Zhanqi , Chang Hou-Tai 

TITLE=Hyperbaric oxygen therapy as rescue therapy for pediatric frosted branch angiitis with Purtscher-like retinopathy: A case report

JOURNAL=Frontiers in Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1119623

DOI=10.3389/fmed.2023.1119623

ISSN=2296-858X

ABSTRACT=Background: Frosted branch angiitis (FBA) is an uncommon uveitis characterized by fulminant retinal vasculitis. Purtscher-like retinopathy (PuR) is a rare retinal angiopathy associated with a non-traumatic etiology. Both FBA and PuR can cause profound visual impairments. To present a case with Hyperbaric oxygen therapy as rescue therapy for pediatric frosted branch angiitis with Purtscher-like retinopathy. 
Case presentation: We describe the case of a 10-year-old male who presented with sudden bilateral painless visual loss due to FBA with concurrent PuR, with notable viral prodrome one month prior to presentation. Systemic investigations revealed a recent herpes simplex virus 2 infection with a high titer of IgM, positive antinuclear antibody(ANA)(1:640), and abnormal liver function tests. After administration of systemic corticosteroids, anti-viral agents, and subsequent immunosuppressive medications, the FBA was gradually alleviated. However, fundoscopy and optical coherence tomography revealed persistent PuR and macular ischemia. Hence, hyperbaric oxygen therapy was administered as a rescue strategy, which resulted to gradual bilateral visual acuity improvement.
Conclusions: Hyperbaric oxygen therapy may be a beneficial rescue treatment for retinal ischemia secondary to frosted branch angiitis with Purtscher-like retinopathy.