The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology (한방안이비인후피부과학회지)

The Society of Korean Medicine Ophthalmology, Otolaryngology & Dermatology (대한한방안이비인후피부과학회)
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Acupuncture for glaucoma: A systematic review and meta-analysis of randomized controlled trials

녹내장의 침치료 효과에 대한 체계적 문헌고찰 및 메타분석

  • 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)
  • 이길희 (동국대학교 한방안이비인후피부과교실) ;
  • 정찬영 (동국대학교 일산한방병원 침구과) ;
  • 장석주 (동국대학교 일산한방병원 한방소아청소년과) ;
  • 홍승욱 (동국대학교 일산한방병원 한방안이비인후피부과)
  • Received : 2020.06.01
  • Accepted : 2020.07.26
  • Published : 2020.08.25
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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

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