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http://dx.doi.org/10.6114/jkood.2020.33.3.045

Acupuncture for glaucoma: A systematic review and meta-analysis of randomized controlled trials  

Yi, Gil-Hee (Department of Ophthalmology & Otolaryngology & Dermatology, Graduate School of Dongguk University)
Jung, Chan-Yung (Department of Acupuncture and Moxibustion, Dongguk University Ilsan Oriental Hospital)
Chang, Seok-Joo (Department of Pediatrics of Korean Medicine, Dongguk University Ilsan Oriental Hospital)
Hong, Seung-Ug (Department of Ophthalmology & Otolaryngology & Dermatology, Dongguk University Ilsan Oriental Hospital)
Publication Information
The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology / v.33, no.3, 2020 , pp. 45-68 More about this Journal
Abstract
Objectives : This study aims to evaluate the effectiveness and safety of manual and electroacupuncture on glaucoma. Method : We searched 11 electronic databases using index words to identify randomized clinical trials. Meta-analysis of weighted mean difference (WMD) or standardized mean difference (SMD) were used to evaluate the outcomes. Cochrane bias risk assessment tool was used to assess the risk of bias in each clinical study. The collected data was analyzed using RevMan software (ver. 5.3). Results : At the initial stage of data retrieval, 549 papers were searched. After reviewing 37 full texts, a total of 10 RCT studies (426patients, 715 eyes) were selected and 8 RCT studies (357 people, 617 eyes) were involved in meta-analysis. Meta-analysis of 8 RCTs showed that acupuncture alone was more effective in reducing intraocular pressure(IOP) than conventional treatment (WMD = -5.73, 95% CI: [-12.30, 0.83], P = 0.09, I2 = 97%) The combination of acupuncture or electroacupuncture with conventional treatment was also effective in lowering IOP (WMD = -1.84, 95% CI: [-2.31, -1.37], P <0.00001, I2 = 45%). It was estimated that the combination of acupuncture with conventional treatment was also effective for improving visual field (VF) (WMD = -2.17, 95% CI: [-4.32, -0.02], P = 0.05, I2 = 89%) but improvement in visual acuity (VA) was not significant (MD = 0.06, 95% CI: [-0.03, 0.15], P = 0.23, I2 = 0%). Subgroup analyzes were performed only for the studies that used open glaucoma as the study's disease and combination of acupuncture or electroacupuncture with conventional therapy would have an effect on lowering intraocular pressure (WMD = -1.68)., 95% CI: [-2.46, -0.90], P <0.0001, I2 = 29%). Conclusion : This study suggests that acupuncture treatment for glaucoma may be effective in reducing intraocular pressure and helpful in improving visual field defects. However, due to the small sample size, high risk of bias and high heterogeneity in the methodology, it is expected that further studies will be needed to verify the results. Further studies in large-scale samples based on a minimized biased methodology would be necessary.
Keywords
Glaucoma; Intraocular pressure; Acupuncture; Electroacupuncture; Systematic review and Meta-anaylsis;
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