Acupuncture for slowing the progression of myopia in children and adolescents: Cochrane systematic review
Assessed as up to date: 2011/07/08
Myopia (near-sightedness or short-sightedness) is one of the three commonly detected refractive (focusing) errors. Acupuncture is the stimulation of acupuncture points by various methods including needle insertion and acupressure. It is often used by traditional Chinese medicine practitioners to treat myopia in children.Objectives
To assess the effectiveness and safety of acupuncture in slowing the progression of myopia in children and adolescents.Search methods
We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2011, Issue 7), MEDLINE (January 1950 to July 2011), EMBASE (January 1980 to July 2011), the Allied and Complementary Medicine Database (AMED) (January 1985 to July 2011), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to July 2011), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrial.gov), the National Center for Complementary and Alternative Medicine (NCCAM) (The first issue to August 2010), the Chinese Biological Medicine Database (CBM) (1978 to April 2011), China National Knowledge Infrastructure (CNKI) (1994 to April 2011) and VIP (1989 to April 2011). There were no date or language restrictions in the electronic searches for trials. CENTRAL, MEDLINE, EMBASE, AMED, LILACS, mRCT and ClinicalTrials.gov were last searched on 9 July 2011. NCCAM was searched up to August 2010 and CBM, CNKI, and VIP were last searched on 6 April 2011.Selection criteria
We included randomized controlled trials (RCTs) that included any type of acupuncture treatment for myopia in children and adolescents.Data collection and analysis
Two authors independently evaluated the search results according to the inclusion and exclusion criteria. Two authors extracted and assessed data independently. We contacted the study investigator for missing data.Main results
We included two RCTs conducted in Taiwan with a total of 131 participants. We did not perform a meta-analysis as the trials were assessing different outcomes. Neither trial met our pre-defined primary outcome criteria of myopia progression defined as one diopter mean change. Only one trial reported the changes of axial length without non-significant difference among groups and both trials reported that several children experienced mild pain during acupuncture stimulation.Authors' conclusions
Two trials are included in this review but no conclusions can be drawn for the benefit of co-acupressure for slowing progress of myopia in children. Further evidence in the form of RCTs are needed before any recommendations can be made for the use of acupuncture treatment in clinical use. These trials should compare acupuncture to placebo and have large sample sizes. Other types of acupuncture (such as auricular acupuncture) should be explored further as well as compliance with treatment for at least six months or longer. Axial length elongation of the eye should be investigated for at least one year. The potential to reduce/eliminate pain from acupuncture experienced by children should also be reviewed.
Wei Mao Ling, Liu Jian Ping, Li Ni, Liu Ming
Acupuncture for near-sightedness in children
Myopia, also called near-sightedness or short-sightedness, is one of the most commonly occurring eye problems in children and adolescents. Early detection and treatment of initial myopia is associated with better outcomes of visual improvement and correction. Myopia is usually managed by wearing glasses and/or contact lenses. It is common practice for traditional Chinese medicine practitioners to use acupuncture for the treatment of myopia. Acupuncture is the stimulation of acupuncture points by needle insertion, acupressure, surface electrical and laser stimulation. This review aimed to assess the effectiveness and safety of acupuncture in slowing the progression of myopia in children and adolescents. We included two studies conducted in Taiwan with a total of 131 school children and did not combine the results as the two trials assessed different outcomes. One study found no significant difference in changes in the length of the eyes. Both studies found several children experienced mild pain while pressing and dropped out. The included studies in this review were unable to provide evidence of the effect of acupuncture for slowing the progression of myopia. More trials should be conducted where acupuncture is compared to placebo, other types of acupuncture are investigated, compliance with treatment for at least six months is explored and axial length elongation of the eye should be for at least one year.
Implications for practice
The current evidence from this review is unable to support the benefit of acupuncture for slowing the progression of myopia in children. Without further evidence, acupuncture treatment cannot be recommended for clinical use. In practice, it is necessary to train the acupuncturist to use the correct acupuncture points, alternative stimulation, frequency of one day or a week to reduce/eliminate the possible pain experienced by children and adolescents from acupuncture treatment for myopia.
Implications for research
The potential role of acupuncture/acupressure alone for slowing down the progression of myopia in children and adolescents should be explored in further placebo-controlled RCTs with large sample sizes. More appropriate types of acupuncture (such as auricular acupuncture) and compliance with treatment should be further explored at least six months and longer. Axial length elongation of the eye should be investigated for at least one year.Get full text at The Cochrane Library
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