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Editors Selection IGR 10-1
Alternative Treatment: Acupuncture in OHT and POAG
Comment by Norbert Pfeiffer on:
21490 Influence of acupuncture on intraocular pressure and compliance of patients with ocular hypertension or primary wide-angle glaucoma: First results of a controlled prospective follow-up study, Ewert H; Schwanitz R, Deutsche Zeitschrift fur Akupunktur, 2008; 51: 13-20
Many glaucoma patients seek additional alternative treatments methods to either add or substitute their treatment. Acupuncture has been suggested to lower IOP in patients with POAG. In a prospective unmasked and non-randomized study by Ewert and Schwanitz (1280) 21 patients with POAG, 13 subjects with OHT, and 16 normal controls received two sessions of acupuncture per week over four weeks. Multiple points for acupuncture were selected mainly for ear, liver and eye zone with the aim to induce the De Qi-feeling. IOP was measured before, during and after acupuncture. Medical treatment remained unaltered. While mean IOP was stable in the normal controls (16.21 versus 16.56 mmHg before versus after the last acupuncture treatment), the authors observed a significant reduction in the OHT group (22.38 vs. 18.07 mmHg, respectively. They described a mean reduction in IOP of 3.55 mmHg in the POAG group (mean IOPs of 18.95 vs. 15.4 mmHg). The authors also noted an initial increase in IOP during the individual acupuncture session and for the first three sessions, then followed by a decrease in IOP in all groups but the OHT group.
It still remains to be shown if acupuncture can add to or substitute medical glaucoma treatmentThey also observed a long-lasting effect for up to one year. An additional questionnaire revealed a general improvement in well-being among 76% of participants. Also, the percentage of patients who admitted to use their medications irregularly decreased from initially 28% of patients to 4%. The authors suggest to use acupuncture in patients with contraindications to glaucoma medications. Such results could be most important and might change the face of glaucoma treatment. Most unfortunately this study was not performed in a masked fashion. Thus, the results could be explained by the investigator's expectations. More likely, an increase in compliance may explain some, if not all of the effect. Thus, it still remains to be shown if acupuncture can add to or substitute medical glaucoma treatment. A randomized, double masked study comparing acupuncture and sham treatment should be performed to clarify the subject, because until then patients will continue to seek such treatment whether we like it or not.
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