title: Adjunctive effect of acupuncture to refractive correction on anisometropic amblyopia: one-year results of a randomized crossover trial.
abstract: OBJECTIVE
  To evaluate the safety and adjunctive effect of acupuncture added to refractive correction for anisometropic amblyopia in younger children.
  
  
  METHODS
  Prospective, randomized, controlled, crossover trial.
  
  
  METHODS
  We included 83 children aged 3 to <7 years with untreated anisometropic amblyopia and baseline best-corrected visual acuity (BCVA) of 20/40 to 20/200 in the amblyopic eye.
  
  
  METHODS
  Participants were randomized to receive spectacles alone (group 1; n = 42) or spectacles + acupuncture (group 2; n = 41) for 15 weeks, and were then crossed over to receive the other regimen for another 15 weeks. The BCVA in both eyes was measured at baseline and every 5 (±1) weeks for the initial 45 weeks and at 60 (±1) weeks.
  
  
  METHODS
  BCVA in the amblyopic eye at 15, 30, and 60 weeks.
  
  
  RESULTS
  The mean baseline BCVA in the amblyopic eye was 0.50 and 0.49 logarithm of the minimum angle of resolution (logMAR) in groups 1 and 2, respectively. After 15 weeks of treatment, the BCVA had improved by a mean of 2.2 lines in group 1 and 2.9 lines in group 2. The mean difference in BCVA between groups was 0.77 lines (95% confidence interval (CI), 0.29-1.3; P = 0.0020) with baseline adjustment. BCVA of ≤0.1 logMAR was achieved in 14.6% of the patients in group 1 and 57.5% in group 2 (P<0.00010). After the regimens were crossed over at 30 weeks, group 1 had a mean of 1.2 (95% CI, 0.98-1.48; P = 2.0 × 10⁻¹²) lines additional improvement from the 15-week BCVA, whereas in group 2 the mean improvement was 0.4 (95% CI, 0.19-0.63; P = 0.0010) lines. The proportions of responders, resolution, and participants achieving a BCVA of ≤0.1 logMAR at 30 weeks were similar between groups. After completion of acupuncture, only 1 participant had >1 line of VA decrease to 60 weeks. Acupuncture was well-tolerated by all children, and no severe adverse effect was encountered.
  
  
  CONCLUSIONS
  Acupuncture is a potentially useful complementary treatment modality that may provide sustainable adjunctive effect to refractive correction for anisometropic amblyopia in young children. Further large-scale studies seem warranted.
  
  
  BACKGROUND
  Proprietary or commercial disclosure may be found after the references.
authors: Department of Ophthalmology and Visual Sciences, the Chinese University of Hong Kong, Hong Kong, China. dennislam_pub@cuhk.edu.hk
authors: Dennis S C
authors: DS
authors: Lam
authors: Jianhao
authors: J
authors: Zhao
authors: Li Jia
authors: LJ
authors: Chen
authors: Yunxiu
authors: Y
authors: Wang
authors: Chongren
authors: C
authors: Zheng
authors: Qiaoer
authors: Q
authors: Lin
authors: Srinivas K
authors: SK
authors: Rao
authors: Dorothy S P
authors: DS
authors: Fan
authors: Mingzhi
authors: M
authors: Zhang
authors: Ping Chung
authors: PC
authors: Leung
authors: Robert
authors: R
authors: Ritch
mesh_terms: D015670:Acupuncture Therapy; D000550:Amblyopia / Q000503:physiopathology / Q000628:therapy*; D015858:Anisometropia / Q000503:physiopathology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005139:Eyeglasses; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology