Alston C. Lundgren, MD

ABSTRACT Background

Age-related macular degeneration (AMD) is the major cause of vision loss in older people. An earlier publication reported preliminary data. This follow-up report confirms earlier results and expands treatment parameters. Objectives To evaluate the efficacy and safety of acupuncture to treat AMD and to explore treatment parameters. Design, Setting, and Patients Case series of 108 patients (56 women/52 men, median age 76.1 years [range 47-96 years]), seen at a single private practice in New Mexico (US) in 2003-2004. All patients were diagnosed by their ophthalmologist as having macular degeneration. Thirty-two percent (32%) of eyes had wet AMD, 50% dry, and 18% were not specified. Intervention An acupuncture approach combining periorbital electrical stimulation, ear acupuncture, and a French Energetic technique was applied to each patient. Main Outcome Measures Increase in visual acuity measured by Early Detection and Treatment of Diabetic Retinopathy Studies (EDTRS) charts. Results Overall, 69% of patients improved in distant vision and 69% improved in near vision. Patients with both wet and dry forms of AMD benefited equally. Half of patients had subjective vision improvement, 33% of patients gained more than 2 lines on EDTRS charts, 20% reported lessening or disappearance of scotomas, 7% of patients noted improved color vision. The only complication was an occasional ecchymosis and recovery was uneventful. Conclusion Visual acuity in AMD may be improved by acupuncture. Further research is necessary to optimize the protocol and elucidate the mechanism of action.


An Acupuncture Protocol For Treatment Of Age-Related Macular Degeneration: A Second Report

Abstract
ABSTRACT | METHODS | RESULTS | COMMENT | AUTHOR INFORMATION | REFERENCES

Objective  To compare the effectiveness of 2-hour daily patching with the effectiveness of acupuncture in treating anisometropic amblyopia in children aged 7 to 12 years who have worn optimal spectacles for at least 16 weeks.
Methods  In a single-center randomized controlled trial, 88 eligible children with an amblyopic eye who had a best spectacle-corrected visual acuity (BSCVA) of 0.3 to 0.8 logMAR at baseline were randomly assigned to receive 2 hours of patching of the sound eye daily or 5 sessions of acupuncture weekly. All participants in our study received constant optical correction, plus 1 hour of near-vision activities daily, and were followed up at weeks 5, 10, 15, and 25. The main outcome measure was BSCVA in the amblyopic eye at 15 weeks.
Results  The mean BSCVA of the amblyopic eye at 15 weeks improved from baseline by 1.83 and 2.27 lines in the patching and acupuncture groups, respectively. After baseline adjustment, the mean difference of BSCVA between the 2 groups was 0.049 logMAR (95% confidence interval, 0.005-0.092; P = .03), meeting the definition of equivalence (difference within 1 line). The BSCVA had improved by 2 lines or more in 28 (66.7%) and 31 (75.6%) eyes in the patching and acupuncture groups, respectively. Amblyopia was resolved in 7 (16.7%) and 17 (41.5%) eyes in the patching and acupuncture groups, respectively.
Conclusion  Acupuncture produced equivalent treatment effect for anisometropic amblyopia, compared with patching, and was statistically superior. Further studies are warranted to investigate its value in the treatment of amblyopia.
Clinical Relevance  Acupuncture could potentially become an alternative treatment to occlusion therapy for amblyopia.





Medical Acupuncture For Age-Related Macular Degeneration: A Preliminary Report Alston C. Lundgren, MD


ABSTRACT Background

    Age-related macular degeneration (ARMD) is a common cause of vision loss in older people. The efficacy of acupuncture to treat ARMD is unknown. Objective     To evaluate the efficacy and safety of acupuncture to treat ARMD. Design, Setting, and Patients     Case series of 10 women and men (age range, 52-90 years) seen at a single private practice in Santa Fe, New Mexico. Visual acuity ranged from 20/50 to 20/1205. Intervention     An acupuncture approach combining ear points, direct ocular nerve stimulation, a French Energetic technique, with electroacupuncture was applied to each patient 2 times weekly until no further improvement in acuity was noted. Main Outcome Measures    Increase in visual acuity, subjectively recognized by the patient and quantitatively clinically confirmed with an eye chart. Results     Eight of the 10 patients experienced improved visual acuity as measured on MNRead Eye Charts or Optec Vision Screen Machine. There was no degradation of acuity during follow-up, even up to 6 months later. The only reported complication was an occasional ecchymosis, and recovery was uneventful. Conclusion     Visual acuity attenuation in ARMD may be significantly improved by acupuncture. The mechanism is unknown. KEY WORDS Acupuncture, Auriculotherapy, Age-Related Macular Degeneration, Visual Impairment



BMC Complement Altern Med. 2013 Nov 7;13:306. doi: 10.1186/1472-6882-13-306.
Eye exercises of acupoints: their impact on refractive error and visual symptoms in Chinese urban children.
Lin Z, Vasudevan B, Jhanji V, Gao TY, Wang NL, Wang Q, Wang J, Ciuffreda KJ, Liang YB1.
Author information


Abstract
BACKGROUND:
Traditional Chinese eye exercises of acupoints involve acupoint self-massage. These have been advocated as a compulsory measure to reduce ocular fatigue, as well as to retard the development of myopia, among Chinese school children. This study evaluated the impact of these eye exercises among Chinese urban children.
METHODS:
409 children (195 males, 47.7%), aged 11.1 ± 3.2 (range 6-17) years, from the Beijing Myopia Progression Study (BMPS) were recruited. All had completed the eye exercise questionnaire, the convergence insufficiency symptom survey (CISS), and a cycloplegic autorefraction. Among these, 395 (96.6%) performed the eye exercises of acupoints. Multiple logistic regressions for myopia and multiple linear regressions for the CISS score (after adjusting for age, gender, average parental refractive error, and time spent doing near work and outdoor activity) for the different items of the eye exercises questionnaire were performed.
RESULTS:
Only the univariate odds ratio (95% confidence interval) for "seriousness of attitude" towards performing the eye exercises of acupoints (0.51, 0.33-0.78) showed a protective effect towards myopia. However, none of the odds ratios were significant after adjusting for the confounding factors. The univariate and multiple β coefficients for the CISS score were -2.47 (p = 0.002) and -1.65 (p = 0.039), -3.57 (p = 0.002) and -2.35 (p = 0.042), and -2.40 (p = 0.003) and -2.29 (p = 0.004), for attitude, speed of exercise, and acquaintance with acupoints, respectively, which were all significant.
CONCLUSIONS:
The traditional Chinese eye exercises of acupoints appeared to have a modest effect on relieving near vision symptoms among Chinese urban children aged 6 to 17 years. However, no remarkable effect on reducing myopia was observed.



J Acupunct Meridian Stud. 2016 Oct;9(5):267-274. doi: 10.1016/j.jams.2016.01.017. Epub 2016 Feb 17.
Amblyopia: Can Laser Acupuncture be an Option?
Vanzini M, Gallamini M.
Abstract
This paper describes the results of the treatment of amblyopia in young patients using an unconventional laser-acupuncture technique. After obtaining satisfactory results in the treatment of a 14-year-old amblyopic girl, the treatment was applied to 13 amblyopic children aged 3-11 years, with an encouraging outcome. An ultralow-light-intensity laser with a square-wave modulated emission was applied over a sequence of acupuncture points. Each session lasted < 15 minutes, and the treatment was performed once a week in 6-week cycles. Patients were followed for several years to evaluate the long-term results and/or to extend the treatment. All except two of the treated patients showed a rapid increase in visual acuity after several treatment sessions. Some required retreatment for regressions in visual acuity. The need for medium-term treatment cycles seems, however, to suggest that results may not be stable for all individuals. Although acupuncture has already been proved to be effective in the treatment of amblyopia, the results reported in this paper suggest that laser acupuncture at ultra-low-light-intensity levels can provide similar, if not better, results to conventional acupuncture stimulation, but with higher patient compliance.
Copyright © 2016. Published by Elsevier B.V.

Alston C. Lundgren, MD