Blechschmidt Tilo, Krumsiek Maike, Todorova Margarita G
Department of Ophthalmology, University of Basel, Mittlere Strasse 91, CH-4031 Basel, Switzerland.
Medicines (Basel). 2017 May 23;4(2):33. doi: 10.3390/medicines4020033.
The aim of this study is to examine the short-term effect of visual function following acupuncture treatment in patients with congenital idiopathic nystagmus and acquired nystagmus (CIN and AN). An observational pilot study on six patients with confirmed diagnosis of nystagmus (three CIN and three AN patients (2♀, 4♂; mean age 42.67; SD ± 20.57 y)), was performed. Acupuncture treatment was done following a standardized protocol applying needle-acupuncture on the body and the ears. The treatment was scheduled with 10 sessions of 30 min duration over five weeks. To assess the effect of the treatment, we performed before, between, and after acupuncture objective measurement of the BCVA (EDTRS charts), contrast vision (CSV-1000, Vector Vision), nystagmography (Compact Integrated Pupillograph), complemented by evaluation questionnaires. A placebo non-acupuncture control group (Nr: 11, 22 eyes; 8♀, 3♂; mean age: 33.34 y (SD ± 7.33 y)) was taken for comparison. The results showed that, following acupuncture treatment, CIN and AN patients showed improvement (SD± mean) in their binocular BCVA (baseline: 0.45 ± 0.36; between: 0.53 ± 0.34 and post-treatment: 0.51 ± 0.28), and in their monocular contrast sensitivity (baseline: 11.29 ± 12.35; between: 11.43 ± 11.45 and post-treatment: 14.0 ± 12.22). The post-/baseline-difference showed a significant improvement in contrast vision and in BCVA for CIN and AN patients, but not for controls ( = 0.029 and = 0.007, respectively). The effect of the eye showed also, within CIN and AN, significant values for the examined parameters in the post-/baseline difference ( = 0.004 and ≤ 0.001). Evaluated only binocularly, the respective between-/baseline and post-/baseline difference in the CIN and AN group showed significant values ( < 0.045). Two AN patients reported reduction of oscillations. Among general subjective symptoms, our patients reported reduction of tiredness and headache attacks, improvement of vision, and shorter sleep onset time. The applied acupuncture protocol showed improvement in the visual function of nystagmus patients and thus, in their quality of life. Further studies are mandatory to differentiate which group of nystagmus patients would benefit more from acupuncture.
本研究旨在探讨针刺治疗对先天性特发性眼球震颤和后天性眼球震颤(CIN和AN)患者视觉功能的短期影响。对6例确诊为眼球震颤的患者(3例CIN和3例AN患者(2♀,4♂;平均年龄42.67岁;标准差±20.57岁))进行了一项观察性试点研究。针刺治疗按照标准化方案进行,包括体针和耳针。治疗安排为在五周内进行10次,每次30分钟。为评估治疗效果,我们在针刺前、针刺期间和针刺后对最佳矫正视力(EDTRS视力表)、对比敏感度(CSV - 1000,Vector Vision)、眼震电图(Compact Integrated Pupillograph)进行了客观测量,并辅以评估问卷。选取了一个安慰剂非针刺对照组(n = 11,22只眼;8♀,3♂;平均年龄:33.34岁(标准差±7.33岁))进行比较。结果显示,针刺治疗后,CIN和AN患者的双眼最佳矫正视力(基线:0.45±0.36;针刺期间:0.53±0.34;治疗后:0.51±0.28)以及单眼对比敏感度(基线:11.29±12.35;针刺期间:11.43±11.45;治疗后:14.0±12.22)均有所改善。CIN和AN患者治疗后/基线差异显示对比敏感度和最佳矫正视力有显著改善,但对照组无改善(分别为P = 0.029和P = 0.007)。在CIN和AN组内,眼的效应在治疗后/基线差异的检查参数中也显示出显著值(P = 0.004和P≤0.001)。仅进行双眼评估时,CIN和AN组各自的针刺期间/基线和治疗后/基线差异显示出显著值(P < 0.045)。2例AN患者报告眼球震颤减轻。在一般主观症状方面,我们的患者报告疲劳和头痛发作减少、视力改善以及入睡时间缩短。所应用的针刺方案显示出眼球震颤患者视觉功能的改善,从而改善了他们的生活质量。需要进一步研究以区分哪一组眼球震颤患者从针刺中获益更多。