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Rédacteur : Johan Nguyen
Sommaire
macular degeneration
Dégénérescence maculaire : évaluation de l'acupuncture
1. Systematic Reviews and Meta-Analysis
1.1. Chen 2025
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
| Background | Degenerative 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. |
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| Methods | A 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. |
| Results | A 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. |
| Conclusion | Acupuncture 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. Sun 2023
Sun W, Zhao Y, Liao L, Wang X, Wei Q, Chao G, Zhou J. Effects of acupuncture on age-related macular degeneration: A systematic review and meta-analysis of randomized controlled trials. PLoS One. 2023 Mar 23;18(3):e0283375. https://doi.org/10.1371/journal.pone.0283375
| Background | In recent years, an increasing number of patients with age-related macular degeneration (AMD) have received acupuncture treatment, but there has been no systematic review to evaluate the effect of acupuncture on patients with AMD. |
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| Purpose | This meta-analysis aims to review the clinical efficacy of acupuncture in the treatment of AMD. |
| Methods | Randomized controlled trials up to September 4, 2022 were searched in the following databases: PubMed, Ovid Medline, Embase, Cochrane Library, The Chinese National Knowledge Infrastructure Database, VIP, Wanfang, and SINOMED. Two reviewers independently performed literature screening and data extraction. RevMan 5.4 was used for the meta-analysis. |
| Results | Nine of the 226 articles were finally included. A total of 508 AMD patients (631 eyes) were enrolled, including 360 dry eyes and 271 wet eyes. The results showed that acupuncture alone or as an adjunct therapy improved both the clinical efficacy and best-corrected visual acuity (BCVA) of AMD patients and reduced their central macular thickness. The certainty of the evidence ranged from “low” to “very low”. |
| Conclusion | There is no high-quality evidence that acupuncture is effective in treating patients with AMD; patients with dry AMD may benefit from acupuncture treatment. Considering the potential of acupuncture treatment for AMD, it is necessary to conduct a rigorously designed randomized controlled trials to verify its efficacy. |
2. Clinical Practice Guidelines
| ⊕ positive recommendation (regardless of the level of evidence reported) Ø negative recommendation (or lack of evidence) |
2.1. American Academy of Ophthalmology (AAO, USA) 2014 Ø
American Academy of Ophthalmology. Age-related macular degeneration. San Francisco (CA): American Academy of Ophthalmology. 2014. 57P. [168196].
| Radiation therapy, acupuncture, electrical stimulation, macular translocation surgery, and adjunctive use of intravitreal corticostroids with verteporfin PDT are not recmmended (III; moderate; strong). |
2.2. American Academy of Ophthalmology (AAO, USA) 2007 Ø
American Academy of Ophthalmology. Acupuncture for age-related macular degeneration. San Francisco (CA): American Academy of Ophthalmology. 2007. 8P . [168163].
| Based on available evidence in the peer-reviewed scientific literature, the Academy believes that there is insufficient scientific evidence to demonstrate the safety or effectiveness of acupuncture for treatment of age-related macular degeneration (AMD). |
