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Randomized controlled trial of patching vs acupuncture for anisometropic amblyopia in children aged 7 to 12 years
Jianhao Zhao1, Dennis S C Lam, Li Jia Chen
1Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, China.
Insights
Acupuncture and patching showed equivalent results for treating anisometropic amblyopia in children. Acupuncture was statistically superior, suggesting it could be an alternative to patching for amblyopia treatment.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Integrative Medicine
Background:
- Anisometropic amblyopia is a common cause of reduced vision in children.
- Traditional treatment involves patching the stronger eye to improve vision in the amblyopic eye.
- Novel therapeutic approaches are being explored to enhance treatment efficacy.
Purpose of the Study:
- To compare the effectiveness of daily 2-hour patching versus acupuncture in treating anisometropic amblyopia.
- To evaluate treatment outcomes in children aged 7 to 12 years with optimal spectacle correction.
Main Methods:
- A single-center randomized controlled trial included 88 children with anisometropic amblyopia.
- Participants received either 2 hours of daily patching or 5 weekly acupuncture sessions.
- Best spectacle-corrected visual acuity (BSCVA) in the amblyopic eye was the primary outcome measure at 15 weeks.
Main Results:
- Both patching and acupuncture improved BSCVA, with acupuncture showing a slightly greater mean improvement.
- The mean difference in BSCVA between groups was statistically equivalent (0.049 logMAR).
- Amblyopia resolution occurred in 41.5% of the acupuncture group versus 16.7% of the patching group.
Conclusions:
- Acupuncture demonstrated equivalent and statistically superior treatment effects compared to patching for anisometropic amblyopia.
- Acupuncture presents a potential alternative to traditional occlusion therapy for amblyopia.
- Further research is recommended to explore the full potential of acupuncture in amblyopia management.
Objective:
To compare the effectiveness of 2-hour daily patching with the effectiveness of acupuncture in treating anisometropic amblyopia in children aged 7 to 12 years who have worn optimal spectacles for at least 16 weeks.
Methods:
In a single-center randomized controlled trial, 88 eligible children with an amblyopic eye who had a best spectacle-corrected visual acuity (BSCVA) of 0.3 to 0.8 logMAR at baseline were randomly assigned to receive 2 hours of patching of the sound eye daily or 5 sessions of acupuncture weekly. All participants in our study received constant optical correction, plus 1 hour of near-vision activities daily, and were followed up at weeks 5, 10, 15, and 25. The main outcome measure was BSCVA in the amblyopic eye at 15 weeks.
Results:
The mean BSCVA of the amblyopic eye at 15 weeks improved from baseline by 1.83 and 2.27 lines in the patching and acupuncture groups, respectively. After baseline adjustment, the mean difference of BSCVA between the 2 groups was 0.049 logMAR (95% confidence interval, 0.005-0.092; P = .03), meeting the definition of equivalence (difference within 1 line). The BSCVA had improved by 2 lines or more in 28 (66.7%) and 31 (75.6%) eyes in the patching and acupuncture groups, respectively. Amblyopia was resolved in 7 (16.7%) and 17 (41.5%) eyes in the patching and acupuncture groups, respectively.
Conclusion:
Acupuncture produced equivalent treatment effect for anisometropic amblyopia, compared with patching, and was statistically superior. Further studies are warranted to investigate its value in the treatment of amblyopia.
Clinical Relevance:
Acupuncture could potentially become an alternative treatment to occlusion therapy for amblyopia.
Trial Registration:
Centers for Clinical Trials Registry Identifier: CUHK_CCT00248.
