A pilot study of an acupuncture protocol to improve visual function in retinitis
pigmentosa patients
Ava K Bittner OD PhD1,
Jeffrey M Gould MEd LAc2,
Andy Rosenfarb ND LAc3,
Collin Rozanskshayu0112256@sina.comi1,
Gislin Dagnelie PhD1
Article first published online: 29 OCT 2013
Keywords:
acupuncture;
low vision;
retinitis pigmentosa
Background
Patients with retinitis pigmentosa are motivated to try complementary or
integrative therapies to slow disease progression. Basic science, clinical
research and retinitis pigmentosa patients' self-reports support the
hypothesis that acupuncture may improve visual function.
Methods
A prospective, case series, pilot study enrolled 12 adult patients with RP
treated at an academic medical centre with a standardised protocol that
combined electroacupuncture to the forehead and below the eyes and
acupuncture to the body, at 10 half-hour sessions over two weeks. Pre- and
post-treatment tests included Early Treatment Diabetic Retinopathy Study
visual acuity (VA), Pelli-Robson contrast sensitivity (CS), Goldmann visual
fields, and dark-adapted full-field stimulus threshold (FST)(n = 9). Scotopic
Sensitivity Tester-1 (SST-1) dark-adaptometry was performed on the last two
subjects.
Results
Six of 12 subjects had measurable, significant visual function improvements
after treatment. Three of nine subjects tested with the FST had a significant
10.3 to 17.5 dB (that is, 13- to 53-fold) improvement in both eyes at one
week after acupuncture, maintained for at least 10 to 12 months, which was
well outside typical test-retest variability (95% CI: 3-3.5 dB) previously found
in retinitis pigmentosa. SST-1 dark-adaptation was shortened in both
subjects tested on average by 48.5 per cent at one week (range 36 to 62 per
cent across 10 to 30 dB), which was outside typical coefficients of variation
of less than 30 per cent previously determined in patients with retinitis
pigmentosa and normals. Four of the five subjects with psychophysically
measured scotopic sensitivity improvements reported subjective
improvements in vision at night or in dark environments. One subject had 0.2
logMAR improvement in VA; another had 0.55 logCS improvement. Another
subject developed more than 20 per cent improvement in the area of the
Goldmann visual fields. The acupuncture protocol was completed and well
tolerated by all, without adverse events or visual loss.
Conclusions
Acupuncture entails minimal risk, if administered by a well-trained
acupuncturist and may have significant, measurable benefits on residual
visual function in patients with retinitis pigmentosa, in particular scotopic
sensitivity, which had not previously been studied. These preliminary findings
support the need for future controlled studies of potential mechanisms. |
