Adjunctive effect of acupuncture to refractive correction on anisometropic amblyopia: one-year results of a randomized crossover trial

To evaluate the safety and adjunctive effect of acupuncture added to refractive correction for anisometropic amblyopia in younger children. Prospective, randomized, controlled, crossover trial. We included 83 children aged 3 to <7 years with untreated anisometropic amblyopia and baseline best-cor...

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Vydáno v:Ophthalmology (Rochester, Minn.) Ročník 118; číslo 8; s. 1501
Hlavní autoři: Lam, Dennis S C, Zhao, Jianhao, Chen, Li Jia, Wang, Yunxiu, Zheng, Chongren, Lin, Qiaoer, Rao, Srinivas K, Fan, Dorothy S P, Zhang, Mingzhi, Leung, Ping Chung, Ritch, Robert
Médium: Journal Article
Jazyk:angličtina
Vydáno: United States 01.08.2011
Témata:
Acupuncture Therapy
Amblyopia - physiopathology
Amblyopia - therapy
Anisometropia - physiopathology
Anisometropia - therapy
Child
Child, Preschool
Combined Modality Therapy
Cross-Over Studies
Double-Blind Method
Eyeglasses
Female
Follow-Up Studies
Humans
Male
Prospective Studies
Treatment Outcome
Visual Acuity - physiology
ISSN:1549-4713, 1549-4713
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Shrnutí:To evaluate the safety and adjunctive effect of acupuncture added to refractive correction for anisometropic amblyopia in younger children. Prospective, randomized, controlled, crossover trial. We included 83 children aged 3 to <7 years with untreated anisometropic amblyopia and baseline best-corrected visual acuity (BCVA) of 20/40 to 20/200 in the amblyopic eye. Participants were randomized to receive spectacles alone (group 1; n = 42) or spectacles + acupuncture (group 2; n = 41) for 15 weeks, and were then crossed over to receive the other regimen for another 15 weeks. The BCVA in both eyes was measured at baseline and every 5 (±1) weeks for the initial 45 weeks and at 60 (±1) weeks. BCVA in the amblyopic eye at 15, 30, and 60 weeks. The mean baseline BCVA in the amblyopic eye was 0.50 and 0.49 logarithm of the minimum angle of resolution (logMAR) in groups 1 and 2, respectively. After 15 weeks of treatment, the BCVA had improved by a mean of 2.2 lines in group 1 and 2.9 lines in group 2. The mean difference in BCVA between groups was 0.77 lines (95% confidence interval (CI), 0.29-1.3; P = 0.0020) with baseline adjustment. BCVA of ≤0.1 logMAR was achieved in 14.6% of the patients in group 1 and 57.5% in group 2 (P<0.00010). After the regimens were crossed over at 30 weeks, group 1 had a mean of 1.2 (95% CI, 0.98-1.48; P = 2.0 × 10⁻¹²) lines additional improvement from the 15-week BCVA, whereas in group 2 the mean improvement was 0.4 (95% CI, 0.19-0.63; P = 0.0010) lines. The proportions of responders, resolution, and participants achieving a BCVA of ≤0.1 logMAR at 30 weeks were similar between groups. After completion of acupuncture, only 1 participant had >1 line of VA decrease to 60 weeks. Acupuncture was well-tolerated by all children, and no severe adverse effect was encountered. Acupuncture is a potentially useful complementary treatment modality that may provide sustainable adjunctive effect to refractive correction for anisometropic amblyopia in young children. Further large-scale studies seem warranted. Proprietary or commercial disclosure may be found after the references.
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ISSN:1549-4713
1549-4713
DOI:10.1016/j.ophtha.2011.01.017