In a research letter published in Clinical Ophthalmology, investigators found that treating dry eye with acupuncture may increase secretory proteins in tear fluid more than eyedrops. These findings suggest that influencing tear protein production may be an appropriate therapeutic strategy to manage dry eye.
Building on a previous study, which investigated tear proteomics changes in patients following acupuncture, researchers conducted a prospective case series with samples from a subgroup of patients from a randomized interventional trial (NCT02219204) to understand better how acupuncture may influence the pathology of dry eye.
The research team included patients with demonstrated lung-kidney yin deficiency and dry eye disease, defined as having a Standardized Patient Evaluation of Eye Dryness (SPEED) score higher than 6, signs of dry eye (tear break-up time <10 seconds, or Schirmer’s test <10 mm/5 min), and any corneal fluorescein dye staining. Patients with severe meibomian gland dysfunction were not included.
In this study, researchers included 15 patients from the original study who used a lubricant drop and 15 patients who received acupuncture while also using the same lubricant drop. The mean age of the patients in the acupuncture group was 56.9±7.9 years, while the mean age of the drop-only group was 60.3±8.0 years. Regarding sex, 1 of 15 in the acupuncture group and 5 out of 15 in the drop-only group were men. The mean SPEED scores were 13.7±4.1 and 12.7±4.8 in the acupuncture and drop-only group, respectively. Tear break-up times were 2.3±0.7 seconds and 1.8±0.6 seconds, respectively. Schirmer test results were 11.8±6.6 mm and 15.3±7.2 mm, respectively, suggesting that these patients did not have aqueous-deficient dry eye, according to researchers.
Patients in the acupuncture group underwent 8 sessions of acupuncture for 4 weeks, and both groups were treated 4 times a day with the lubricant drop. Tear samples from all patients were collected at baseline and at the end of week 4.
Researchers define a “responsive” tear protein change as an increase in supportive proteins and a decrease in inflammatory proteins. They found that 9 of the 15 patients who received acupuncture showed a responsive protein change, compared with 4 out of 15 patients treated with the drop alone.
“The trend of changes in the lacrimal proteins suggests that acupuncture may induce an increase in tear production,” according to the report. “It is not possible to determine from the data whether this increase was primarily a reflex or a basal production, or secondary to reduced inflammatory damage to the secreting glands.”
Limitations to this study include its small sample size and its use of data from another study.
Tong L, Zhou L, Koh SK, et al. Changes in tear proteome after acupuncture treatment in dry eye. Clin Ophthalmol. Published online December 1, 2021. doi:10.2147/OPTH.S334942.