Abstract
Purpose :
To determine the feasibility, clinical and functional effects of the Santa Fe Protocol for dry Age-Related Macular Degeneration (AMD).
Methods :
Ten patients diagnosed with dry AMD were recruited following strict inclusion criteria, and all study visits were conducted at the Center for Integrative Eye Care at the UPMC Eye Institute. Ten acupuncture treatment sessions were completed within 20 weeks with National Eye Institute Visual Functioning Questionnaire-25 (VFQ-25), ETDRS visual acuity testing, Rosenbaum Pocket Vision Screener for near vision, slit lamp, and fundus exam, optical coherence tomography (OCT), and fundus autofluorescence (AF) images collected at baseline, in-between visits, and 3-months and 6-months after completion of sessions. FAF and OCT images were assessed for drusenoid pigment epithelial detachment, confluent drusen, and migration of hyperreflective material to monitor risk of progression to advanced AMD.
The main outcomes were changes in distance and near visual acuity, and quality of life. Secondary outcome measures include central retinal thickness assessed through OCT imaging and size of geographic atrophy (GA) area. Given the limited sample size of this pilot study, descriptive analysis was performed on all variables.
Results :
10 patients (5 females, mean age 74.2 (Standard Deviation [SD]= 6.8) years, with a majority of Caucasians (90%) with dry AMD in both eyes were recruited with 1 lost to follow-up before completion of sessions and one after. 88.9% of patients (16/18 eyes) had improvement in distance vision and 77.8% (14/18 eyes) in near vision at the end of the sessions. Improvement was noted in VFQ Composite Score 10 eyes after at 3-month post-completion of sessions, a number which declined at the 6-month visit. Average retinal thickness decreased to 236.9 µm from baseline of 245.4 µm by the 3-month follow-up visit. The average GA area for 9 patients increased from 4.77 mm2 (SD= 5.50 mm2) to 5.24 mm2 (SD= 6.02 mm2) from the time of evaluation to the 3-month follow-up. All patients reported subjective improvements in vision following acupuncture treatments.
Conclusions :
Acupuncture could be a viable option to improve visual functioning and quality of life in patients seeking an alternative treatment option for nonexudative AMD. Further investigation is needed to expand upon our observations.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.