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Acupuncture for glaucoma

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Abstract

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Background

Glaucoma is a multifactorial optic neuropathy in which there is an acquired loss of retinal ganglion cells at levels beyond normal age‐related loss and corresponding atrophy of the optic nerve. Although there are many existing treatments, glaucoma is a chronic condition. Some patients may seek complementary or alternative medicine such as acupuncture to supplement their regular treatment. The underlying plausibility of acupuncture is that disorders related to the flow of Chi (the traditional Chinese concept translated as vital force or energy) can be prevented or treated by stimulating the relevant points on the body surface.

Objectives

The objective of this review was to assess the effectiveness and safety of acupuncture in people with glaucoma.

Search methods

We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2010, Issue 3), MEDLINE (January 1950 to March 2010), EMBASE (January 1980 to March 2010), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to March 2010), ZETOC (January 1993 to March 2010), Allied and Complementary Medicine Database (AMED) (January 1985 to March 2010), the metaRegister of Controlled Trials (mRCT) (www.controlled‐trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the National Center for Complementary and Alternative Medicine web site (NCCAM) (http://nccam.nih.gov). There were no language or date restrictions in the search for trials. The electronic databases were last searched on 23 March 2010 with the exception of NCCAM which was last searched on 14 July 2010. We also handsearched Chinese medical journals at Peking Union Medical College Library in April 2007.

Although the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Chinese Acupuncture Trials Register, the Traditional Chinese Medical Literature Analysis and Retrieval System (TCMLARS), and the Chinese Biological Database (CBM) were searched for the original review, we did not search these databases for the 2010 review update.

Selection criteria

We planned to include randomized and quasi‐randomized clinical trials in which one arm of the study involved acupuncture treatment.

Data collection and analysis

Two authors independently evaluated the search results against the inclusion and exclusion criteria. Discrepancies were resolved by discussion.

Main results

We found no randomized clinical trials and subsequently no meta‐analysis was conducted. Evidence was limited to a few case series of small sample size.

Authors' conclusions

At this time, it is impossible to draw reliable conclusions from the available data to support the use of acupuncture for the treatment of glaucoma. Since most glaucoma patients currently cared for by ophthalmologists do not use non‐traditional therapy, the clinical practice decisions will have to be based on physician judgement and patients' value given this lack of data in the literature.

PICOs

Population
Intervention
Comparison
Outcome

The PICO model is widely used and taught in evidence-based health care as a strategy for formulating questions and search strategies and for characterizing clinical studies or meta-analyses. PICO stands for four different potential components of a clinical question: Patient, Population or Problem; Intervention; Comparison; Outcome.

See more on using PICO in the Cochrane Handbook.

Plain language summary

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Acupuncture as a treatment modality for patients with glaucoma

Glaucoma is a leading cause of blindness worldwide. Although there are many existing treatments, including the use of eye drops, laser treatment, and a variety of surgical procedures, some patients may seek complementary or alternative medicine such as acupuncture to supplement their regular treatment. This review aimed to evaluate available evidence of the effectiveness and safety of acupuncture in treating patients with glaucoma. We did not find any randomized clinical trials on the subject. The limited information from a few case series highlights the gap in the existing evidence. At this point, the effectiveness of acupuncture as a therapeutic modality for glaucoma could not be established.