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Editors Selection IGR 15-2

Miscellaneous: Acupuncture

Comment by Nathan Congdon on:

53826 Acupuncture for glaucoma, Law SK; Li T, Cochrane Database of Systematic Reviews, 2013; 5: CD006030

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This Cochrane review describes a carefully- performed and exhaustive examination of published trials on the subject of acupuncture for glaucoma treatment. The review concludes that the current literature, consisting of only a single completed trial examining auricular pressure in the treatment of intraocular pressure, does not provide sufficient information to reach reliable conclusions about acupuncture treatment for glaucoma. One other trial described in English and seven more in Chinese have not yet been completed.

The authors also point out that it is unlikely that trials comparing acupuncture alone with standard treatments would be ethically acceptable in most settings in view of the fact that standard pressure- lowering therapies have been established as efficacious in the treatment of this disease.

This review has made a valuable contribution in calling attention to a large number of ongoing trials of acupuncture for glaucoma described only in the Chineselanguage literature, and which would otherwise be unknown to English-speaking readers

The importance of this study rests on recent research demonstrating that use of complementary therapies for glaucoma is widespread.¹ This review has made a valuable contribution in calling attention to a large number of ongoing trials of acupuncture for glaucoma described only in the Chinese-language literature, and which would otherwise be unknown to English-speaking readers. The authors propose to update their review when these studies are completed. The plausibility of acupuncture treatment for glaucoma and other conditions is a somewhat complex matter, and depends upon a model of human physiology, as postulated by Chinese medicine, which emphasizes the importance of regulating the flow of qi, or vital force, by manipulating key points on the body surface. The location of these points and in fact the proposed flow of qi itself does not generally correspond to western medical models.

Though this paper does not contain information of direct relevance to clinical practice at this time, it would seem that the widespread use of acupuncture and other qi-directing therapies over long periods of time make them worthy of further careful study. Reviews such as the present one which bring together work in both English and Chinese will provide an important service in keeping interested practitioners up to date in this area.

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