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Ava Bittner, Jeff Gould, Collin Rozanski, Andy Rosenfarb, Marius DeJong, Alexandra Benavente-Perez, Gislin Dagnelie; Visual Function Improvements following Electroacupuncture for Retinitis Pigmentosa. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4017. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Retinitis pigmentosa (RP) patients are motivated to try alternative therapies to slow disease progression. Basic science, clinical research and patients’ self-reports support the hypothesis that electroacupuncture may improve visual function in RP, which we explored in a case series study.
A standard protocol involving electroacupuncture to the forehead and below the eyes, and acupuncture to the body, was administered to 12 RP patients at 10 half-hour sessions over 2 weeks. Pre- and post-treatment tests included ETDRS visual acuity (VA), Pelli-Robson contrast sensitivity (CS), Goldmann visual fields, dark-adapted full-field stimulus test (FST)(n=9), SST-1 dark-adaptometry (n=2), and Heidelberg Spectralis spectral domain optical coherence tomography (SD-OCT). We measured ocular blood flow (OBF) in the ophthalmic artery (OA), central retinal artery (CRA), and posterior ciliary artery (PCA) with color Doppler imaging (Philips iU-22) in the last 2 subjects.
Eight of 12 subjects had a measurable, significant visual function improvement post-treatment. Three of the first 9 subjects had a significant 10.3-17.5dB (i.e. 13-53 fold) improvement in FST in both eyes at 1 week, maintained for at least 4-6 months, well outside typical test-retest variability (95% CI: 3-3.5dB) in RP. Dark-adaptation with the SST-1 was shortened in both subjects tested on average by 44% at 1 week (range 36-62% across 10-30dB), outside typical coefficients of variation of <30% previously determined in RP and normals. Three subjects had ≥0.1 logMAR VA improvement, and another subject had 0.55 logCS improvement. Both subjects with cystoid macular edema (CME) pre-treatment developed a reduction. At 1-2 weeks post-treatment, there was a significant reduction in the OA resistance index (RI) in both subjects, as well as in the CRA and PCA RI in subjects 11 and 12, respectively. Subject 11 had increased OA and CRA end diastolic velocities (EDV), and subject 12 had increased CRA and PCA peak systolic and EDV. Electro- and standard acupuncture was well tolerated by all, without adverse events or vision loss.
Electro- and standard acupuncture entails minimal risk and may have measurable benefits on residual visual function, while other promising treatments are developed. Current findings support the need to explore potential mechanisms and more rigorous methodology in the continued study of electroacupuncture for RP.
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