Dr. Granet on TV, a pediatric ophthalmologist in San Diego.

Dr. Granet makes some nice statements on this segment of The Doctors TV Show. In describing the relevance of screening a young child for amblyopia, he states: “The eye is just a camera, and then you have to get it back to the CPU, the central processor. The brain waves tell us what she can see or can’t see. Amblyopia is when the brain isn’t using one eye.”

Acupuncture treatments to treat one type of lazy eye proved as good as the traditional patching of the eye used to help the eyes work together, according to a new study.

”Acupuncture could potentially become an alternative treatment to occlusion [patching] therapy for ambylopia [lazy eye], the researchers write. The study, conducted in China, is published in the Archives of Ophthalmology.

U.S. experts familiar with the study call it interesting but say the treatment needs more study and wonder if it would catch on in the U.S.

Acupuncture for Lazy Eye Vs. Patching: Study Details

While some previous research has found acupuncture for lazy eye effective, the researchers couldn’t find a study that directly compared acupuncture with conventional treatments such as patching.

So Dennis Lam, MD, a researcher at the Joint Shantou International Eye Center of Shantou University and Chinese University of Hong Kong, and his colleagues evaluated 88 children, ages 7 to 12, with the condition known as anisometropic amblyopia, in which there is a difference in the degree of nearsightedness or farsightedness between the two eyes.

They assigned 43 children to the acupuncture group, and they received five treatments a week. Acupuncturists used five different points in the head, face, hand, and leg.

The children were instructed to do an hour per day of near-vision activities such as homework or computer work.

Another 45 children wore a patch over their normal eye for two hours daily, a typical regimen, and were also asked to do an hour of near-vision activity a day.

Acupuncture for Lazy Eye vs. Patching: Results

At 15 weeks, visual acuity with eyeglasses improved by about 1.8 lines on the vision chart in the patched eyes and 2.3 lines in those who had acupuncture.

An improvement of two lines or more occurred in nearly 67% of those in the patching group but nearly 76% of those in the acupuncture group.

Ambylopia was evaluated as resolved in nearly 17% of patched eyes but nearly 42% of the acupuncture group.

”These results suggest that the treatment effect of acupuncture is equivalent to that of patching for anisometropic amblyopia in older children,” Lam writes.

But at 25 weeks, the resolution rates were similar in the two groups: 30% of the patched group and 42% of the acupuncture group.

Acupuncture for Lazy Eye: A Closer Look

Lam can’t explain exactly how the acupuncture for lazy eye might work. Acupuncture has been shown to increase blood flow to the brain and eye, stimulating retinal nerve growth factors and leading to metabolic changes in the central nervous system, he writes.

These actions may explain the effect on the amblyopia, he speculates.

Acupuncture vs. Patching

Two experts who reviewed the study for WebMD but were not involved in it call the study scientifically sound, but they note that it is small and that acupuncture is much more widely accepted in China than elsewhere.

”The amount of improvement here, almost two lines [on the eye chart], is a lot,” says Michael Repka, MD, a professor of ophthalmology and pediatrics at the Johns Hopkins University School of Medicine’s Wilmer Eye Institute in Baltimore.

However, he notes, it is an initial report and a single study.

Some of the improvement could have come from wearing glasses, he says.

“There’s a time commitment for this,” he says of the acupuncture. “These kids went five days a week.” He also cites expense and parent time to get the child to the acupuncturist as potential drawbacks.

The patch is typically worn two hours a day, can be worn at home, and is inexpensive, he says.

The extra time to go to an acupuncturist may be a drawback, agrees Matthew Gearinger, MD, an associate professor of ophthalmology and medicine at the Flaum Eye Institute at the University of Rochester School of Medicine.

The fear of needles, he says, is probably not much of a problem with the older children studied. “You can probably talk them into it,” he says.

If a U.S. parent wanted to try acupuncture to help their child’s anisometropic amblyopia, Gearinger says he would probably agree, with continued follow-up with an ophthalmologist.

High concentrations of plasma total homocysteine are known to be associated with the risk of developing diabetes-related cardiovascular disease, nephropathy and proliferative retinopathy.

A trial published in the November, 2010 National Review of Endocrinology suggests adverse outcomes associated with co-supplementation of high-dose vitamin B6, folate and B12 in patients with advanced diabetic nephropathy.

The trial, Diabetic Intervention with Vitamins to Improve Nephropathy (DIVIN), enrolled 238 subjects with type 1 or type 2 diabetes and advanced diabetic nephropathy for a period of 36 months.  The active ingredient patients in the randomized controlled trial were treated with 25 mg of B-6 as pyridoxine, 2.5 mg folic acid and 1.0 mg vitamin B12.  118 subjects remained in the 36 month study for the primary outcome.

Plasma homocysteine concentration was decreased in the subjects taking the three B vitamins as expected, but an unexpected decline in renal function, as determined by a decrease of the glomerular filtration rate, resulted in an increased number of vascular disease events, defined as a composite of myocardial infarction, stroke, and all cause mortality with an outcome of 23.5% in the B vitamin group vs. 14.4% in the placebo group.

The Homocysteinemia in Kidney and End Stage Renal Disease (HOST) study included 2,056 patients with advanced kidney disease and found no effect of high-dose vitamin B6, B9 and B12 supplements on survival or risk of cardiovascular disease-related events.

One of the investigators of the Diabetic Intervention with Vitamins to Improve Nephropathy trial speculates that the adverse effects observed in the DIVIN study may be due to accumulation of folate and vitamin B12 to toxic levels owing to the low glomerular filtration rate in patients with diabetic nephropathy.   He also went on to say that not all B-vitamins are the same and praised the pilot studies that found high dose thiamine (B-1) supplementation on patients with type 2 diabetes and early-stage diabetic nephropathy improved renal function in all patients treated.

Do the thiamine, B-6, folate and B-12 studies suggest that it might not make biological sense to fragment supplemental B vitamins?

Biosyntrx CEO / Chief Research Officer