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Rédacteur : Johan Nguyen

Sommaire

General Ophthalmology

Ophtalmologie générale : évaluation de l'acupuncture

1. Systematic Reviews and Meta-Analysis

1.1. Chen 2025 (degenerative eye diseases)

Chen KY, Chan HC, Chan CM. Is acupuncture a viable therapeutic strategy for degenerative eye diseases? A systematic review and meta-analysis. Complement Ther Med. 2025 Aug 22;103235. https://doi.org/10.1016/j.ctim.2025.103235

BackgroundDegenerative ocular diseases, including glaucoma, age-related macular degeneration (AMD), optic atrophy, and retinitis pigmentosa (RP), are major causes of irreversible vision loss. Acupuncture, a traditional Chinese therapy, has shown promise in improving visual function through neuroprotective and vascular mechanisms.
MethodsA systematic review and meta-analysis were conducted using PubMed, Embase, Scopus, Web of Science, Google Scholar, and Cochrane Library. Randomized controlled trials, cohort studies, and observational studies evaluating acupuncture or electroacupuncture for degenerative ocular diseases were included. Risk of bias was assessed using RoB 2.0 for RCTs and ROBINS-I for non-randomized studies. Meta-analyses and narrative syntheses were performed using RevMan and rbiostatistics.
ResultsA total of 3,362 records were identified, with 21 studies meeting inclusion criteria. Acupuncture was associated with improvements in visual acuity-related outcomes, ocular blood flow, and intraocular pressure across conditions. Meta-analysis showed a significant improvement in total effective rate favoring acupuncture (OR = 3.52, 95% CI 2.18–5.68, p < 0.00001), with consistent benefits across RP, AMD, and optic atrophy. However, pooled analyses showed no statistically significant improvement in visual acuity (MD = −0.03, p = 0.50) or intraocular pressure (MD = −0.86 mmHg, p = 0.11). Comparisons with sham acupuncture demonstrated non-significant trends. Overall findings were heterogeneous.
ConclusionAcupuncture may offer potential benefits for degenerative eye diseases, particularly in improving clinical response rates. However, its effects on visual acuity and intraocular pressure remain inconclusive, highlighting the need for larger, well-designed studies.

1.2. Welte 2017

Welte AK, Hahn U, Büssing A, Krummenauer F. [Systematic Review of the Application of Complementary and Alternative Medicine and their Potential Therapeutic Benefits in the Treatment of Ophthalmology Patients]. Klin Monbl Augenheilkd. 2017;234(5):686-696. [99927].

PurposeA systematic review was carried out of the reported therapeutic effects of complementary and alternative medicine methods as supplementary or primary treatments for patients suffering from glaucoma, cataract or age-related macular degeneration (AMD).
Material and Methods For the years 1990 to 2013, the following databases were screened for reports of the application of complementary and alternative treatments: PubMed, Cochrane Library, EMBASE, CAMbase and AMED. Both randomised and prospective non-randomised patient trials were included in the review; results were evaluated in the following classes: “phytotherapy”, “acupuncture/acupressure”, “biofeedback” and “other alternative treatments”. The studies were evaluated by measures of clinical effect, statistical significance (p value and/or confidence interval) and the underlying trial design.
Results 30 clinical trials were included, including 13 on glaucoma, 5 on cataract and 12 on AMD patients. These trials were based on patient numbers of 6 - 332, 27 - 157 and 6 - 328 patients, respectively. Phytotherapy was applied in 14 trials, including 6 on glaucoma patients (all 6 with a controlled design, and 3 of which reporting statistically significant results); 5 trials were on cataract patients (3 with a controlled design and 2 with a significant result) and 3 on AMD patients (only 1 with a controlled design, with a significant result). Acupuncture/acupressure was investigated in 9 trials, 5 on glaucoma patients (3 with a controlled design, 1 with a significant result); no acupuncture/acupressure trial was found in cataract patients, but 4 trials in AMD patients (none with a controlled design). Biofeedback was studied in 4 trials, all on AMD patients (only one with a controlled design, without statistically significant findings).
Conclusion Despite its rigorous inclusion criteria, this review identified several clinical trials on complementary and alternative medicine in ophthalmological patients. Phytotherapeutic methods gave significant results in half of the reported controlled trials, whereas there were few significant benefits with acupuncture or acupressure.