title: [Systematic Review of the Application of Complementary and Alternative Medicine and their Potential Therapeutic Benefits in the Treatment of Ophthalmology Patients].
abstract: PurposeA systematic review was carried out of the reported therapeutic effects of complementary and alternative medicine methods as supplementary or primary treatments for patients suffering from glaucoma, cataract or age-related macular degeneration (AMD).Material and MethodsFor the years 1990 to 2013, the following databases were screened for reports of the application of complementary and alternative treatments: PubMed, Cochrane Library, EMBASE, CAMbase and AMED. Both randomised and prospective non-randomised patient trials were included in the review; results were evaluated in the following classes: "phytotherapy", "acupuncture/acupressure", "biofeedback" and "other alternative treatments". The studies were evaluated by measures of clinical effect, statistical significance (p value and/or confidence interval) and the underlying trial design.Results30 clinical trials were included, including 13 on glaucoma, 5 on cataract and 12 on AMD patients. These trials were based on patient numbers of 6 - 332, 27 - 157 and 6 - 328 patients, respectively. Phytotherapy was applied in 14 trials, including 6 on glaucoma patients (all 6 with a controlled design, and 3 of which reporting statistically significant results); 5 trials were on cataract patients (3 with a controlled design and 2 with a significant result) and 3 on AMD patients (only 1 with a controlled design, with a significant result). Acupuncture/acupressure was investigated in 9 trials, 5 on glaucoma patients (3 with a controlled design, 1 with a significant result); no acupuncture/acupressure trial was found in cataract patients, but 4 trials in AMD patients (none with a controlled design). Biofeedback was studied in 4 trials, all on AMD patients (only one with a controlled design, without statistically significant findings).ConclusionDespite its rigorous inclusion criteria, this review identified several clinical trials on complementary and alternative medicine in ophthalmological patients. Phytotherapeutic methods gave significant results in half of the reported controlled trials, whereas there were few significant benefits with acupuncture or acupressure.
authors.affiliation: Institut für Medizinische Biometrie und Epidemiologie, Universität Witten/Herdecke, Witten.
authors.forename: A K
authors.initials: AK
authors.lastname: Welte
authors.affiliation: Institut für Medizinische Biometrie und Epidemiologie, Universität Witten/Herdecke, Witten.
authors.forename: U
authors.initials: U
authors.lastname: Hahn
authors.affiliation: Lehrstuhl für Medizintheorie, Integrative und Anthroposophische Medizin, Professur für Lebensqualität, Spiritualität und Coping, Universität Witten/Herdecke, Witten.
authors.forename: A
authors.initials: A
authors.lastname: Büssing
authors.affiliation: Institut für Medizinische Biometrie und Epidemiologie, Universität Witten/Herdecke, Witten.
authors.forename: F
authors.initials: F
authors.lastname: Krummenauer
mesh_terms: D002386:Cataract / Q000453:epidemiology / Q000628:therapy; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data*; D000529:Complementary Therapies / Q000379:methods* / Q000706:statistics & numerical data*; D019317:Evidence-Based Medicine; D005128:Eye Diseases / Q000453:epidemiology* / Q000628:therapy*; D005901:Glaucoma / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D008268:Macular Degeneration / Q000453:epidemiology / Q000628:therapy; D015995:Prevalence; D016896:Treatment Outcome