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.
Degeneration (ARMD-Aged Related Macular Degeneration) is the slow deterioration of the cells in the macula, a tiny yellowish area near the center of the retina. The macula functions to give us clear central vision and fine detailed images. The deterioration of the macula affects an individual's central vision -the ability to read, write and drive and recognizing faces -among other visual abnormalities. There are two types of macular degeneration, wet and dry. Ninety percent of people with macular degeneration have the dry-type in which small, yellow spots called Drusen form underneath the macula. Drusen are believed to be metabolic waste products that accumulate and cause cellular damage. It has been suggested that Drusen slowly breaks down the cells of the macula, causing distorted vision.Dry macular degeneration can progress into the second, more severe type, called wet-type macular degeneration. The cause of this progression is unknown to conventional medicine. In wettype ARMD, new, abnormal blood vessels begin to grow toward the macula, causing rapid and severe vision loss. These weak blood vessels can rupture and bleed, thus "wet-type" ARMD. Both wet and dry ARMD are diagnosed by an ophthalmologist and there is currently no safe and effective conventional treatment.Individual risk factors for macular degeneration have been identified as contributing factors to the development and progression of ARMD. These include: female gender, smoking (increase risk by 200-300%), diabetics, high blood pressure (uncontrolled) and family history of macular degeneration.
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