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Zhi Y, Cai M, Du R, Qiao Y, Zheng X, Xu G, Yan L, Wu D. Quantitative evaluation of anisometropic amblyopia treatment efficacy by coupling multiple visual functions via CRITIC algorithm. BMC Ophthalmol 2023; 23:162. [PMID: 37072762 PMCID: PMC10114397 DOI: 10.1186/s12886-023-02898-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 04/02/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND The evaluation of amblyopia treatment efficacy is essential for amblyopia prevention, control, and rehabilitation. METHODS To evaluate the amblyopia treatment efficacy more precisely and quantitatively, this study recorded four visual function examination results, i.e., visual acuity, binocular rivalry balance point, perceptual eye position, and stereopsis before and after amblyopia treatment. RESULTS We found that all these four results had a significant difference between before and after treatment, and the relationship between visual acuity improvement and the difference of BRBP, PEP, and stereoacuity cannot show a fitting correlation regarding the widely used index of visual acuity as the standard of treatment efficacy. By using the Criteria Importance Through Inter-criteria Correlation (CRITIC) method, a more comprehensive and quantitative index by coupling the selected four indexes with objective weights was obtained for further training efficacy representation, and the validation dataset also showed a good performance. CONCLUSIONS This study proved that our proposed coupling method based on different visual function examination results via the CRITIC algorithm is a potential means to quantify the amblyopia treatment efficacy.
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Affiliation(s)
- Ying Zhi
- Department of Ophthalmology, First Affiliated Hospital of Northwest University, Xi'an, China
- Department of Ophthalmology, Xi'an No. 1 Hospital, Xi'an, China
| | - Min Cai
- Department of Ophthalmology, First Affiliated Hospital of Northwest University, Xi'an, China.
- Department of Ophthalmology, Xi'an No. 1 Hospital, Xi'an, China.
| | - Rui Du
- Department of Ophthalmology, First Affiliated Hospital of Northwest University, Xi'an, China
- Department of Ophthalmology, Xi'an No. 1 Hospital, Xi'an, China
| | - Ying Qiao
- Department of Ophthalmology, First Affiliated Hospital of Northwest University, Xi'an, China
- Department of Ophthalmology, Xi'an No. 1 Hospital, Xi'an, China
| | - Xiaowei Zheng
- School of Mathematics, Northwest University, Xi'an, China
| | - Guanghua Xu
- School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, China
| | - Li Yan
- National Engineering Research Center for Healthcare Devices, Guangzhou, China
| | - Dianpeng Wu
- National Engineering Research Center for Healthcare Devices, Guangzhou, China
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Jaber D, Ghannam RA, Rashed W, Shehadeh M, Zyoud SH. Use of complementary and alternative therapies by patients with eye diseases: a hospital-based cross-sectional study from Palestine. BMC Complement Med Ther 2021; 21:3. [PMID: 33397355 PMCID: PMC7784325 DOI: 10.1186/s12906-020-03188-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 12/14/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Generally, complementary and alternative therapies (CAT) are accepted methods of treatment by patients with various types of conditions. Their use is becoming especially prevalent among patients with eye problems even in developed countries. Thus, we aimed to determine the pattern of use of CAT in this patient population, to identify the patient characteristics associated with the use of CAT, and to assess the types of CAT used. METHODS A descriptive, cross-sectional study was conducted in Palestine at An-Najah National University Hospital between the time periods of October 2019 to May 2020, using questionnaire-based face to face interviews. Data were collected through convenience sampling. Patients responded to the questionnaire, which was focused on information adapted from previous research in this area, covering socio-demographic and clinical characteristics, types of CAT, source of information, and side effects on CAT use. RESULTS A total of 86 patients were interviewed for our study. Over two thirds, 67% reported using CAT for the specific purpose of improving their eye condition, and about one third (29.1%) received more than one therapy. The most common therapies reported were duea' (i.e. supplication) (47.1%) and herbal therapies (24.1%). It was shown that patients with bilateral involvement of their eyes were almost twice more likely to describe using CAT than patients with unilateral eye pathology (p = 0.006). Also, patients who underwent surgery as their route of treatment were significantly less likely to use CAT (p = 0.043). Most of our study participants mentioned a non-physician source as their source of information regarding CAT with family members being the most frequently mentioned (30.2%) followed by the internet (25.6%) and friends (19.8%). CONCLUSIONS The prevalence of CAT use among patients with eye disease is somewhat high in our study population. Because CAT may trigger adverse reactions, influence the progression of the disease, and interfere with conventional treatment, the ophthalmologist should frequently be asked patients with such diagnostics regarding the use of these therapies. Further work is required to analyze the mechanisms of action and to establish realistic guidelines for the use of these modalities.
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Affiliation(s)
- Dania Jaber
- grid.11942.3f0000 0004 0631 5695Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Rafat Abu Ghannam
- grid.11942.3f0000 0004 0631 5695Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Waleed Rashed
- grid.11942.3f0000 0004 0631 5695Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Mohammad Shehadeh
- grid.11942.3f0000 0004 0631 5695Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- grid.11942.3f0000 0004 0631 5695Department of Ophthalmology, An-Najah National University Hospital, 44839 Nablus, Palestine
| | - Sa’ed H. Zyoud
- grid.11942.3f0000 0004 0631 5695Department of Clinical and Community Pharmacy, Department of Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- grid.11942.3f0000 0004 0631 5695Poison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- grid.11942.3f0000 0004 0631 5695Clinical Research Center, An-Najah National University Hospital, Nablus, 44839 Palestine
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3
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Chen J, Zhang L, Gan X, Zhang R, He Y, Lv Q, Fu H, Liu X, Miao L. Effects of Retinal Transcription Regulation After GB20 Needling Treatment in Retina With Optic Neuritis. Front Integr Neurosci 2020; 14:568449. [PMID: 33117136 PMCID: PMC7550785 DOI: 10.3389/fnint.2020.568449] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 08/13/2020] [Indexed: 11/13/2022] Open
Abstract
Optic neuritis (ON) is one of the most frequent symptoms of multiple sclerosis (MS) that results in progressive loss of axons and neurons. In clinical trials of Traditional Chinese Medicine, needling at the GB20 acupoint has been widely used for the treatment of ocular diseases, including ON. However, the molecular mechanisms of needling at this site are still unclear. In this study, we generated an experimental autoimmune encephalomyelitis (EAE) mouse model and investigated the effects of needling treatment at the GB20 acupoint on retina with EAE-associated ON. RNA sequencing of the retinal transcriptome revealed that, of the 234 differentially expressed genes induced by ON, 100 genes were upregulated, and 134 genes were downregulated by ON, while needling at the GB20 acupoint specifically reversed the expression of 21 genes compared with control treatment at GV16 acupoint. Among the reversed genes, Nr4a3, Sncg, Uchl1, and Tppp3 were involved in axon development and regeneration and were downregulated by ON, indicating the beneficial effect of needling at GB20. Further gene ontology (GO) enrichment analysis revealed that needling at GB20 affected the molecular process of Circadian rhythm in mouse retina with ON. Our study first reported that needling treatment after ON at the GB20 acupoint regulated gene expression of the retina and reversed the expression of downregulated axon development-related genes. This study also demonstrated that GV16 was a perfect control treatment site for GB20 in animal research. Our study provided a scientific basis for needling treatments at GB20 for ocular diseases.
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Affiliation(s)
- Jie Chen
- Beijing Advanced Innovation Center for Intelligent Robots and Systems, Beijing Institute of Technology, Beijing, China.,School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Li Zhang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Xiulun Gan
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Rong Zhang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Yinjia He
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Qiuyi Lv
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Haonan Fu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Xiaodong Liu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Linqing Miao
- Beijing Advanced Innovation Center for Intelligent Robots and Systems, Beijing Institute of Technology, Beijing, China.,School of Mechatronical Engineering, Beijing Institute of Technology, Beijing, China
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4
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Ji Z, Zhang J, Menniti-Ippolito F, Massari M, Fauci AJ, Li N, Yang F, Zhang M. The quality of Cochrane systematic reviews of acupuncture: an overview. BMC Complement Med Ther 2020; 20:307. [PMID: 33054785 PMCID: PMC7556594 DOI: 10.1186/s12906-020-03099-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 09/29/2020] [Indexed: 12/26/2022] Open
Abstract
Background Many systematic reviews of clinical trials on acupuncture were performed within the Cochrane Collaboration, the evidence-based medicine (EBM) most recognized organization. Objective of the article was to systematically collect and identify systematic reviews of acupuncture published in the Cochrane Library and assess their quality from a methodological perspective. Methods A comprehensive literature search was performed in the Cochrane Database of Systematic Reviews to identify the reviews of acupuncture conducted until June 2019. The methodological quality of the included reviews was assessed using the AMSTAR 2 checklist, an evaluation tool for systematic reviews. Results Out of a total of 126 eligible reviews, 50 systematic reviews were included. According to the AMSTAR 2, 52% of Cochrane Systematic Reviews (CSRs) were of low quality, due to the presence of one or more weaknesses in at least one of the domains defined as critical for the methodological quality assessment. The less satisfied critical domain was inadequate investigation and discussion of publication bias. Declaration of potential sources of conflict of interest, and funding of the authors of the review and of the included studies were other important weaknesses. Conclusions The main methodological flaws in the included CSRs were related to topics of relatively new concern in the conduction of systematic reviews of the literature. However, both, lack of attention about retrieval of negative studies, and statements about conflict of interests are crucial point for the evaluation of therapeutic interventions according to EBM methodology.
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Affiliation(s)
- Zhaochen Ji
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Junhua Zhang
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
| | | | | | | | - Na Li
- School of Social and Political Sciences, Institute of health and wellbeing, University of Glasgow, Glasgow, UK
| | - Fengwen Yang
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Mingyan Zhang
- Evidence-Based Medicine Center, Tianjin University of Traditional Chinese Medicine, Tianjin, China
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5
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Chen SY, Yieh FS, Liao WL, Li TC, Hsieh CL. Effect of Acupuncture on Intraocular Pressure in Glaucoma Patients: A Single-Blinded, Randomized, Controlled Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2020; 2020:7208081. [PMID: 32419820 PMCID: PMC7204356 DOI: 10.1155/2020/7208081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 04/03/2020] [Accepted: 04/15/2020] [Indexed: 11/17/2022]
Abstract
Glaucoma is characterized by the degeneration of retinal ganglion cells that cause progressive optic neuropathy, finally resulting in changes to the optic nerve head. Lowering intraocular pressure (IOP) is the only method proven for treating glaucoma. Several studies have discovered that acupuncture can reduce IOP and also increase ocular perfusion and ocular blood flow. Therefore, the present study investigated the effect of acupuncture on IOP in glaucoma patients. We conducted a single-blinded, randomized, controlled trial involving 45 glaucoma patients. The results indicated that the difference between the IOP 60 min after the intervention and IOP immediately before the intervention was greater in the acupuncture group (AG) and electroacupuncture group (EG) than in the sham group (SG) for all four of the interventions performed and in both eyes (all p < 0.05). The IOP difference between immediately before the first intervention and after finishing the final intervention was also greater in the AG and EG than in the SG in both eyes (all p < 0.05). In conclusion, IOP was reduced at 60 min after acupuncture or electroacupuncture was performed at BL1 and EX-HN7. Additionally, IOP was reduced after finishing four acupuncture or electroacupuncture sessions. Therefore, our results suggest that acupuncture and electroacupuncture are beneficial for lowering IOP in glaucoma patients. This trial is registered with NCT04157530.
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Affiliation(s)
- Shu-Yuan Chen
- Graduate Institute of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan
| | | | - Wen-Ling Liao
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan
- Center for Personalized Medicine, China Medical University Hospital, Taichung, 40402, Taiwan
| | - Tsai-Chung Li
- Graduate Institute of Biostatistics, College of Public Health, China Medical University, Taichung 40402, Taiwan
- Department of Healthcare Administration, College of Health Science, Asia University, Taichung 413, Taiwan
| | - Ching-Liang Hsieh
- Chinese Medicine Research Center, China Medical University, Taichung 40402, Taiwan
- Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan
- Department of Chinese Medicine, China Medical University Hospital, Taichung 40447, Taiwan
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6
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Abstract
BACKGROUND Glaucoma is a multi-factorial optic neuropathy characterized by an acquired loss of retinal ganglion cells at levels beyond normal age-related loss and corresponding atrophy of the optic nerve. Although many treatments are available to manage glaucoma, patients may seek complementary or alternative medicine approaches such as acupuncture to supplement their regular treatment. The underlying plausibility of acupuncture is that disorders related to the flow of Chi (traditional Chinese concept of vital force or energy) can be managed by stimulating relevant points on the body surface. OBJECTIVES To assess the effectiveness and safety of acupuncture compared with other treatments, no treatment, or placebo in patients with glaucoma. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), which contains the Cochrane Eyes and Vision Trials Register (2018, Issue 11); Ovid MEDLINE; Embase.com; the Cumulative Index to Nursing and Allied Health Literature (CINAHL); the Allied and Complementary Medicine Database (AMED); PubMed; Latin American and Caribbean Literature on Health Sciences (LILACS); ZETOC; the metaRegister of Controlled Trials (mRCT); ClinicalTrials.gov; the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP); and the National Center for Complementary and Alternative Medicine (NCCAM) website. We did not use any language or date restrictions in the search for trials. We last searched electronic databases on November 16, 2018, with the exception of NCCAM, which we last searched on July 14, 2010, and the metaRegister of Controlled Trials (mRCT), which we last searched on January 8, 2013. We handsearched Chinese medical journals at Peking Union Medical College Library in April 2007. We searched the Chinese Acupuncture Trials Register, the Traditional Chinese Medical Literature Analysis and Retrieval System (TCMLARS), the Chinese Biological Database (CBM), and the China National Knowledge Infrastructure (CNKI). We last searched Chinese electronic databases on November 19, 2018. SELECTION CRITERIA We included randomized controlled trials (RCTs) in which one arm involved acupuncture treatment. DATA COLLECTION AND ANALYSIS Two review authors independently screened results, then extracted the data and assessed risk of bias for eligible trials. MAIN RESULTS We included three completed trials and one ongoing trial in the 2019 update of this review. The three completed trials, conducted in Taiwan and the United States, included participants with glaucoma or intraocular hypertension. The interventions investigated varied across trials. One trial compared auricular acupressure-a non-standard acupuncture technique-with the sham procedure in 33 patients. Another trial compared transcutaneous electrical nerve stimulation (TENS) with a sham procedure in 82 patients. The third trial compared 12 sessions of acupuncture on eye-points versus on non-eye-points in 22 patients. All three trials were rated at high risk of bias for at least one domain. The certainty of evidence across all outcomes was very low due to high risk of bias in at least one contributing study; substantial clinical heterogeneity and methodological heterogeneity; and imprecision of results. One trial reported change in the visual field from baseline without any between-group comparison. Because of the quantity of missing data (50%), we did not calculate a between-group comparison, as the quantitative results are difficult to interpret. All three trials reported data for estimation of reduction of intraocular pressure (IOP). However, time points of IOP measurement varied. For the trial comparing acupressure to a sham procedure, the difference in IOP reduction (measured in mm Hg) is estimated to be -3.70 (95% confidence interval [CI] -7.11 to -0.29) for the right eye and -4.90 (95% CI -8.08 to -1.72) for the left eye at four weeks, and -1.30 mm Hg (95% CI -4.78 to 2.18) for the right eye and -2.30 mm Hg (95% CI -5.73 to 1.13) for the left eye at eight weeks. For the trial comparing TENS to sham treatment, the difference reduction is estimated to be -2.81 (95% CI -3.8 to -1.84) for the right eye and -2.58 (95% CI -3.36 to -1.80) for the left eye immediately after treatment, -2.93 (95% CI -3.72 to -2.13) for the right eye and -3.56 (95% CI -4.35 to 2.78) for the left eye 30 minutes after treatment, and finally -3.61 (95% CI -4.47 to -2.75) for the right eye and -3.61 (95% -4.47 to -2.74) for the left eye. For the trial that compared acupuncture on eye-points versus non-eye-points, 11 out of 22 (50%) participants did not complete the treatment. One trial reported data for estimation of visual acuity. When acupressure is compared to sham treatment, the difference in uncorrected visual acuity (UCVA, measured in logMAR) is estimated to be -0.01 (95% CI -0.24 to 0.22) for the right eye and -0.04 (95% CI -0.27 to 0.19) for the left eye at four months, and -0.03 logMAR (95% CI -0.27 to 0.21) for the right eye and -0.16 logMAR (95% CI -0.43 to 0.11) for the left eye at eight months. The difference in best corrected visual acuity (BCVA) is estimated to be 0.10 (95% CI -0.06 to 0.26) for the right eye and 0 (95% CI -0.14 to 0.14) for the left eye at four months, and -0.04 logMAR (95% CI -0.09 to 0.17) for the right eye and -0.04 logMAR (95% CI -0.18 to 0.10) for the left eye at eight months. One trial reported progression of optic disc damage or nerve fiber layer loss without any between-group comparison. Because of the quantity of missing data (50%), we did not calculate a between-group comparison, as the quantitative results are difficult to interpret. One trial reported adverse events in two patients (out of 22) who experienced needle sensitivity. However, the study did not report between-group comparisons. Because of the quantity of missing data (50%), we did not calculate a between-group comparison, as the quantitative results are difficult to interpret. AUTHORS' CONCLUSIONS At this time, it is impossible to draw reliable conclusions from available data to support the use of acupuncture for treatment of patients with glaucoma. Because of ethical considerations, RCTs comparing acupuncture alone with standard glaucoma treatment or placebo are unlikely to be justified in countries where the standard of care has already been established.
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Affiliation(s)
- Simon K Law
- University of California, Los AngelesJules Stein Eye Institute100 Stein Plaza 2‐235Los AngelesCaliforniaUSA90095
| | - Lin Wang
- Johns Hopkins Bloomberg School of Public HealthDepartment of EpidemiologyBaltimoreMarylandUSA
| | - Tianjing Li
- Johns Hopkins Bloomberg School of Public HealthDepartment of EpidemiologyBaltimoreMarylandUSA
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Chen J, Zhang L, Liu L, Yang X, Wu F, Gan X, Zhang R, He Y, Lv Q, Fu H, Zhou L, Zhang J, Liu A, Liu X, Miao L. Acupuncture Treatment Reverses Retinal Gene Expression Induced by Optic Nerve Injury via RNA Sequencing Analysis. Front Integr Neurosci 2019; 13:59. [PMID: 31680887 PMCID: PMC6808026 DOI: 10.3389/fnint.2019.00059] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 09/24/2019] [Indexed: 12/02/2022] Open
Abstract
Glaucoma and traumatic optic nerve crush (ONC) injury result in progressive loss of retinal ganglion cells (RGCs) and defects in visual function. In clinical trials of Traditional Chinese Medicine, acupuncture has been widely used for the treatment of ocular diseases. However, the molecular mechanisms of acupuncture treatment are still unclear. In this study, we used technique of RNA sequencing (RNA-seq) to study the effects of acupuncture treatment on retinal transcriptome after axotomy injury. RNA-seq results revealed that 436 genes including 31 transcription factors (TFs) were changed after injury, among them were many well-known neural degeneration related TFs such as Jun, Ddit3, Atf3, and Atf4. Interestingly, acupuncture treatment at acupoint GB20 (Fengchi) significantly reversed a series of differential expressed genes (DEGs) induced by optic nerve injury. While treatments at BL1 (Jingming) or GB20 sham control acupoint-GV16 (Fengfu), led to limited DEG reversal. In contrast, treatments at these two sites further enhanced the trend of DEG expression induced by axotomy injury. At last, retina immunostaining results revealed that only GB20 acupoint treatment increased RGC survival, in consistent with RNA-seq results. Therefore, our study first reported that acupuncture treatment regulated retinal transcriptome and reversed the gene expression induced by axotomy injury, and GB20 acupoint treatment increased RGC survival, which will provide novel therapeutic targets for treatment of ocular diseases.
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Affiliation(s)
- Jie Chen
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Li Zhang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Lanying Liu
- The Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xueqin Yang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Fengzhi Wu
- Journal Center, Beijing University of Chinese Medicine, Beijing, China
| | - Xiulun Gan
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Rong Zhang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Yinjia He
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Qiuyi Lv
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Haonan Fu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Ling Zhou
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Jiaxi Zhang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Anming Liu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Xiaodong Liu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Linqing Miao
- Beijing Advanced Innovation Center for Intelligent Robots and Systems, Beijing Institute of Technology, Beijing, China
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Zhi FY, Liu J, Ma XP, Hong J, Zhang J, Zhang D, Zhao Y, Wu LJ, Yang YT, Wu DY, Xie C, Wu LX, Zhang CH. Manual Acupuncture for Optic Atrophy: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2019; 2019:1735967. [PMID: 30713567 PMCID: PMC6332962 DOI: 10.1155/2019/1735967] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 11/11/2018] [Accepted: 12/11/2018] [Indexed: 11/18/2022]
Abstract
Objectives. This systematic review aims to critically evaluate the efficacy of manual acupuncture for optic atrophy. Eight English and Chinese databases, including Cochrane Library, EMbase, PubMed, Chinese National Knowledge Infrastructure (CNKI), Wanfang Database, China Science and Technology Journal Database (VIP), and Chinese Biomedical Literature Database (CBM), as well as ongoing trials registered with the WHO International Clinical Trials Registry Platform, were searched to identify eligible randomized controlled trials (RCTs) studying manual acupuncture for optic atrophy compared to medication alone. The quality of evidence was assessed using Cochrane Collaboration's risk of bias tool. Meta-analysis was performed using Review Manager version 5.3. Nine studies were identified and included for meta-analysis. The meta-analysis showed significant differences in favor of manual acupuncture or manual acupuncture plus medication compared with medication alone in the following outcome measures: visual acuity (MD = 0.18, 95% CI [0.17, 0.20], P < 0.00001), mean sensitivity of visual field (MD = 2.11, 95% CI [1.90, 2.32], P < 0.00001), the latent period of P-VEP100 (MD = -6.80, 95% CI [-8.94, -4.66], P < 0.00001), the total effectiveness (264 eyes) (OR = 3.22, 95% CI [1.88, 5.51], P<0.0001), and the total effectiveness (344 participants) (OR = 4.29, 95% CI [2.56, 7.19], P < 0.00001). Despite statistical advantages of manual acupuncture in the literature, due to serious methodological flaws in study design, it cannot be concluded that manual acupuncture is more effective than medicine alone. It is essential that a properly controlled clinical trial is designed and controls are established to exclude placebo effects.
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Affiliation(s)
- Fang-Yuan Zhi
- Shanghai University of Traditional Chinese Medicine, Shanghai 201210, China
| | - Jie Liu
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai 200030, China
| | - Xiao-Peng Ma
- Shanghai University of Traditional Chinese Medicine, Shanghai 201210, China
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai 200030, China
| | - Jue Hong
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai 200030, China
| | - Ji Zhang
- Shanghai University of Traditional Chinese Medicine, Shanghai 201210, China
| | - Dan Zhang
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai 200030, China
| | - Yue Zhao
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai 200030, China
| | - Li-Jie Wu
- Shanghai University of Traditional Chinese Medicine, Shanghai 201210, China
| | - Yan-Ting Yang
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai 200030, China
| | - Dan-Yan Wu
- Shanghai University of Traditional Chinese Medicine, Shanghai 201210, China
| | - Chen Xie
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai 200030, China
| | - Ling-Xiang Wu
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai 200030, China
| | - Cui-Hong Zhang
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai 200030, China
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9
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Leszczynska A, Ramm L, Spoerl E, Pillunat LE, Terai N. The short-term effect of acupuncture on different ocular blood flow parameters in patients with primary open-angle glaucoma: a randomized, clinical study. Clin Ophthalmol 2018; 12:1285-1291. [PMID: 30050281 PMCID: PMC6055908 DOI: 10.2147/opth.s170396] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction To investigate the effect of acupuncture on different ocular blood flow (OBF) parameters in patients with primary open-angle glaucoma (POAG). Patients and methods In a prospective, randomized study, 56 POAG patients were randomly assigned either to an eye-specific acupuncture (group I, n=28) or to an eye-unspecific acupuncture treatment (group II, n=28). Blood flow parameters were measured before and 10 minutes after treatment. Parapapillary retinal blood flow was determined by the Heidelberg retina flowmeter. Retinal vessel diameters were measured by the dynamic vessel analyzer. Pulsatile ocular blood flow, ocular pulse amplitude, and IOP were investigated by the Langham OBF system. Systemic blood pressure was obtained additionally. Results Pulsatile ocular blood flow increased significantly after the eye-specific acupuncture treatment from 5.6±4.3 to 6.7±4.9 µL/min (P=0.014). There was no significant change in parapapillary retinal blood flow, retinal vessel diameter, systemic blood pressure, or IOP after treatment in neither of the two groups. Conclusion An eye-specific acupuncture treatment may affect OBF in POAG patients.
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Affiliation(s)
- Anna Leszczynska
- Department of Ophthalmology, University Hospital Dresden, Dresden, Germany,
| | - Lisa Ramm
- Department of Ophthalmology, University Hospital Dresden, Dresden, Germany,
| | - Eberhard Spoerl
- Department of Ophthalmology, University Hospital Dresden, Dresden, Germany,
| | - Lutz E Pillunat
- Department of Ophthalmology, University Hospital Dresden, Dresden, Germany,
| | - Naim Terai
- Department of Ophthalmology, University Hospital Dresden, Dresden, Germany,
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10
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Abstract
Despite increasing knowledge about the risk factors and clinical findings of nonarteritic anterior ischemic optic neuropathy (NAION), the treatment of this optic neuropathy has remained limited and without clear evidence-based benefit. Historical treatments of NAION are reviewed, beginning with the Ischemic Optic Neuropathy Decompression Trial. More recent treatments are placed within the historical context and illustrate the need for evidence-based therapy for ischemic optic neuropathy.
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11
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Hanna KL, Hepworth LR, Rowe FJ. The treatment methods for post-stroke visual impairment: A systematic review. Brain Behav 2017; 7:e00682. [PMID: 28523224 PMCID: PMC5434187 DOI: 10.1002/brb3.682] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 02/15/2017] [Accepted: 02/16/2017] [Indexed: 12/23/2022] Open
Abstract
AIM To provide a systematic overview of interventions for stroke related visual impairments. METHOD A systematic review of the literature was conducted including randomized controlled trials, controlled trials, cohort studies, observational studies, systematic reviews, and retrospective medical note reviews. All languages were included and translation obtained. This review covers adult participants (aged 18 years or over) diagnosed with a visual impairment as a direct cause of a stroke. Studies which included mixed populations were included if over 50% of the participants had a diagnosis of stroke and were discussed separately. We searched scholarly online resources and hand searched articles and registers of published, unpublished, and ongoing trials. Search terms included a variety of MESH terms and alternatives in relation to stroke and visual conditions. Article selection was performed by two authors independently. Data were extracted by one author and verified by a second. The quality of the evidence and risk of bias was assessed using appropriate tools dependant on the type of article. RESULTS Forty-nine articles (4142 subjects) were included in the review, including an overview of four Cochrane systematic reviews. Interventions appraised included those for visual field loss, ocular motility deficits, reduced central vision, and visual perceptual deficits. CONCLUSION Further high quality randomized controlled trials are required to determine the effectiveness of interventions for treating post-stroke visual impairments. For interventions which are used in practice but do not yet have an evidence base in the literature, it is imperative that these treatments be addressed and evaluated in future studies.
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Affiliation(s)
- Kerry Louise Hanna
- Department of Health Services ResearchUniversity of LiverpoolLiverpoolUK
| | | | - Fiona J. Rowe
- Department of Health Services ResearchUniversity of LiverpoolLiverpoolUK
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12
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Abstract
BACKGROUND Hordeolum is an acute, purulent inflammation of the eyelid margin usually caused by obstructed orifices of the sebaceous glands of the eyelid. The condition, which affects sebaceous glands internally or externally, is common. When the meibomian gland in the tarsal plate is affected, internal hordeolum occurs, while when the glands of Zeis or Moll associated with eyelash follicles are affected, external hordeolum, or stye occurs. The onset of hordeolum is usually self limited, and may resolve in about a week with spontaneous drainage of the abscess. When the condition is severe, it can spread to adjacent glands and tissues. Recurrences are very common. As long as an internal hordeolum remains unresolved, it can develop into a chalazion or generalized eyelid cellulitis. Acupuncture is a traditional Chinese medical therapy aimed to treat disease by using fine needles to stimulate specific points on the body. However, it is unclear if acupuncture is an effective and safe treatment for acute hordeolum. OBJECTIVES The objective of this review was to investigate the effectiveness and safety of acupuncture to treat acute hordeolum compared with no treatment, sham acupuncture, or other active treatment. We also compared the effectiveness and safety of acupuncture plus another treatment with that treatment alone. SEARCH METHODS We searched CENTRAL, Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE, Embase, PubMed, Latin American and Caribbean Health Sciences Literature Database (LILACS), three major Chinese databases, as well as clinical trial registers all through 7 June 2016. We reviewed the reference lists from potentially eligible studies to identify additional randomised clinical trials (RCTs). SELECTION CRITERIA We included RCTs of people diagnosed with acute internal or external hordeola. We included RCTs comparing acupuncture with sham acupuncture or no treatment, other active treatments, or comparing acupuncture plus another treatment versus another treatment alone. DATA COLLECTION AND ANALYSIS We used standard methodological procedures used by Cochrane. MAIN RESULTS We included 6 RCTs with a total of 531 participants from China. The mean age of the participants ranged from 18 to 28 years. Four RCTs included participants diagnosed with initial acute hordeolum with a duration of less than seven days; one RCT included participants diagnosed with initial acute hordeolum without specifying the duration; and one RCT included participants with recurrent acute hordeolum with a mean duration of 24 days. About 55% (291/531) of participants were women. Three RCTs included participants with either external or internal hordeolum; one RCT included participants with only external hordeolum; and two RCTs did not specify the type of hordeolum. Follow-up was no more than seven days after treatment in all included RCTs; no data were available for long-term outcomes. Overall, the certainty of the evidence for all outcomes was low to very low, and we judged all RCTs to be at high or unclear risk of bias.Three RCTs compared acupuncture with conventional treatments. We did not pool the data from these RCTs because the conventional treatments were not similar among trials. Two trials showed that resolution of acute hordeolum was more likely in the acupuncture group when compared with topical antibiotics (1 RCT; 32 participants; risk ratio (RR) 3.60; 95% confidence interval (CI) 1.34 to 9.70; low-certainty of evidence) or oral antibiotics plus warm compresses (1 RCT; 120 participants; RR 1.45; 95% CI 1.18 to 1.78; low-certainty of evidence). In the third trial, little or no difference in resolution of hordeolum was observed when acupuncture was compared with topical antibiotics plus warm compresses (1 RCT; 109 participants; RR 1.00; 95% CI 0.96 to 1.04; low-certainty of evidence). One RCT mentioned adverse outcomes, stating that there was no adverse event associated with acupuncture.Three RCTs compared acupuncture plus conventional treatments (two RCTs used topical antibiotics and warm compresses, one RCT used topical antibiotics only) versus the conventional treatments alone. One of the three RCTs, with very low-certainty evidence, did not report the resolution of acute hordeolum; however, it reported that acute hordeolum relief might be higher when acupuncture was combined with conventional treatments than with conventional treatments alone group (60 participants; RR 1.80; 95% CI 1.00 to 3.23). Pooled analysis of the remaining two RCTs, with low-certainty evidence, estimated resolution of acute hordeolum was slightly higher in the combined treatment group compared with the conventional treatment alone group at 7-day follow-up (210 participants; RR 1.12; 95% CI 1.03 to 1.23; I2 = 0%). None of the three RCTs reported adverse outcomes. Among the included RCTs, four participants, two from the acupuncture plus conventional treatments group and two from the conventional treatments alone group, withdrew due to exacerbation of symptoms. AUTHORS' CONCLUSIONS Low-certainty evidence suggests that acupuncture with or without conventional treatments may provide short-term benefits for treating acute hordeolum when compared with conventional treatments alone. The certainty of the evidence was low to very low mainly due to small sample sizes, inadequate allocation concealment, lack of masking of the outcome assessors, inadequate or unclear randomization method, and a high or unreported number of dropouts. All RCTs were conducted in China, which may limit their generalizability to non-Chinese populations.Because no RCTs included a valid sham acupuncture control, we cannot rule out a potential expectation/placebo effect associated with acupuncture. As resolution is based on clinical observation, the outcome could be influenced by the observer's knowledge of the assigned treatment. Adverse effects of acupuncture were reported sparsely in the included RCTs, and, when reported, were rare. RCTs with better methodology, longer follow-up, and which are conducted among other populations are warranted to provide more general evidence regarding the benefit of acupuncture to treat acute hordeolum.
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Affiliation(s)
- Ke Cheng
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, 1200, Cailun RD, Shanghai, China, 201203
| | - Andrew Law
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, Maryland, USA, 21205
| | - Menghu Guo
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, 1200, Cailun RD, Shanghai, China, 201203
| | - L Susan Wieland
- Center for Integrative Medicine, University of Maryland School of Medicine, 520 W. Lombard Street, Baltimore, Maryland, USA, 21201
| | - Xueyong Shen
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai Research Center of Acupuncture & Meridians, Shanghai Key Laboratory of acupuncture mechanism and acupoint function, 1200, Cailun RD, Shanghai, China, 201203
| | - Lixing Lao
- School of Chinese Medicine, The University of Hong Kong, 10 Sassoon Road, Pokfulam Rd, Hong Kong, Hong Kong, China
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13
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Abstract
This is the protocol for a review and there is no abstract. The objectives are as follows: The primary objective is to assess the role of iridotomy-compared with observation-in the prevention of visual field loss for individuals who have primary angle closure or primary angle-closure glaucoma in at least one eye. We will also examine the role of iridotomy in the prevention of elevated intraocular pressure (IOP) in individuals with narrow angles (primary angle-closure suspect) in at least one eye.
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Affiliation(s)
- Jimmy T Le
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Benjamin Rouse
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Gus Gazzard
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
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14
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Bhartiya S, Ichhpujani P. Complementary and Alternate Management of Glaucoma: The Verdict so Far. J Curr Glaucoma Pract 2014; 8:54-7. [PMID: 26997809 PMCID: PMC4741164 DOI: 10.5005/jp-journals-10008-1161] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Accepted: 04/16/2014] [Indexed: 11/23/2022] Open
Abstract
Complementary and alternative medicine deserves scientific scrutiny as patients with glaucoma often lose vision despite adequate medical or surgical treatment. Most glaucomatologists abstain from recommending alternative medicine as there is little evidence to support most of the recommendations for complementary and alternate management (CAM) use in glaucoma. Megavitamin supplementation has not been shown to have a long-term beneficial effect on glaucoma. In a glaucomatous eye, a very modest benefit of IOP-lowering may be offset by the temporary elevation in IOP that accompanies exercise. There is little evidence to support the use of special diets, acupuncture, relaxation techniques, or therapeutic touch for the treatment of glaucoma. Marijuana can have a profound lowering of IOP, but the low response rate, short half-life, and significant toxicity are strong indicators that it is not an appropriate therapeutic agent. Future research must be carried out to document the effect of CAM not only on IOP, but also on perimetric tests or other objective parameters, such as ocular blood fow and nerve fiber layer thickness. How to cite this article: Bhartiya S, Ichhpujani P. Complementary and Alternate Management of Glaucoma: The Verdict so Far. J Curr Glaucoma Pract 2014;8(2):54-57.
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Affiliation(s)
- Shibal Bhartiya
- Consultant, Department of Ophthalmology, Glaucoma Services, Fortis Memorial Research Institute, Gurgaon, Haryana, India
| | - Parul Ichhpujani
- Assistant Professor, Department of Ophthalmology, Glaucoma Services, Government Medical College and Hospital, Chandigarh, India
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15
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Abstract
This is the protocol for a review and there is no abstract. The objectives are as follows: The objective of this review is to determine the effects and, when possible, the safety of acupuncture for the treatment of acute hordeola, in comparison to no specific treatment (e.g., observation), sham acupuncture, or other active treatments. Acupuncture as an adjuvant to another treatment also will be compared to that treatment alone.
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Affiliation(s)
- Ke Cheng
- College of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xue Wang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Menghu Guo
- College of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - L. Susan Wieland
- Center for Evidence-based Medicine, Brown University Public Health Program, Providence, Rhode Island, USA
| | - Xueyong Shen
- College of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai Research Center of Acupuncture & Meridians, Shanghai, China
| | - Lixing Lao
- School of Chinese Medicine, The University of Hong Kong, Hong Kong, China
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