Stargardt disease

South Baylo University
Capstone Proposal
Jessica Moore
A narrative review of the efficacy of Acupuncture for Stargardt Disease
Doctor of Acupuncture and Oriental medicine
Anaheim, California
Feb 2018
This research paper aims to study Stargardt disease in details and research whether Acupuncture
treatment can be applied to treat Stargardt disease effectively. Stargardt disease is a form of
molecular degeneration which affects the human beings. The paper will also compare the current
western treatment and the Chinese medicine approach and how they are applied to treat the
disease. Currently, we don’t have an appropriate treatment approach for Stargardt disease and
this makes this research very relevant and important. The disease affects the stem cells of the
eyes of the patients and the patients eventually go blind and are left with no hopes of receiving
the required treatment. We have some acupuncturists who claim to treat this disease with
acupuncture and dietary therapy. More studies are required to determine whether acupuncture
can help in slowing the eyes degeneration. For the studies to be done effectively, a large number
of people suffering from Stargardt need to be observed over a long time but this becomes quite
hard since Stargardt affects about only 2% of the people.
Table of contents
I) Introduction
II) Literature review
III) Materials and methods
III) Expected results (optional)
V) References
Chapter 1: Introduction
The purpose of this narrative review is to determine if acupuncture is an appropriate
method of treating Stargardt disease. This is an important topic since there are no current
treatments available in the western medicine for this degenerative blinding disease.
Stargardt disease, also referred to as Stargardt’s macular dystrophy (SMD) or fundus
flavimaculatus is normally characterized by central vision loss in the early stages of life. The
American Macular Degeneration Foundation found that in rare cases about one in 20,000 of
people diagnosed with macular degeneration is normally a child or a teenager.
Stargardt normally affects both eyes and mainly develops at the ages of six to twenty
years where the affected kids get some difficulties in reading or adapting to the bright light. The
causes and the treatment approaches for this disease vary with ages where the causes and the
treatment approaches offered to the young people are different from those of the old people.
Stargardt disease results from a gene called ABCA4 and this gene normally has a
recessive trait. When both the male and the female parents carry this gene, there is a 25% chance
that the children will have Stargardt disease.
Research has shown that Stargardt disease causes serious vision loss problem which
ranges from 20/50 to 20/200 as per the standard eye chart. In the US, legal blindness is normally
defined as a visual acuity of 20/200 or worse and this calls for corrective glasses.
Some of the major symptoms of Stargardt disease include poor eyesight in low lighting,
blurry or distorted vision, and difficulty in recognizing and differentiating familiar faces. In its
late stages, Stargardt can lead to color blindness.
While vitamin A is normally known to be good to the health of the eyes, it’s a different
case to the victims of Stargardt disease as it builds on the retina of the eyes of the patients and
ends up causing partial blindness to the victims.
It remains too early to know whether the cell transplant approach will be possible or not.
The clinical trials to determine if the stem cell treatment is effective and safe are still in the early
stages and their results are yet to be conclusive.
The lack of treatment good treatment options makes it very necessary for us to explore if
acupuncture can be an effective alternative approach for the people with Stargardt.
Chapter 2: Literature Review
It has proved to be very difficult to find any relevant studies related to the use of
acupuncture in treating Stargardt. There were seven articles found which were related to
acupuncture and the eyes. All the seven articles were found to be within 5 years. On acupuncture
and Stargardt, there were no articles found explaining how acupuncture can be applied in treating
Stargardt. These results made us take a step on studying acupuncture and Stargardt.
Many of the studies about acupuncture and the eyes have been done by the Chinese and
up to now we still have much research being done in China about acupuncture. There is a great
need for similar research in America, especially in the doctoral schools. We don’t have any
research going on in South Baylo University which means we have a serious problem with the
Doctoral Programs being offered. My research proposal helped me to understand that my current
Doctoral Program offers no research opportunities and has no future plans for any collaborations
with the many medical schools in this area. This is a major problem for the future of acupuncture
in the future of scientific research.
In a study on retinitis pigmetosa, Ava K Bittner, OD Ph.D., and his colleagues found that
acupuncture can help to improve scotia sensitivity in the eye. These were only preliminary
findings and more research is still needed.
A study on acupuncture reducing the cases of dry eyes done by Blechschmidt, Krumsiek,
and Todorova found that acupuncture was not more effective than the conventional treatment,
but acupuncture had no side effects as compared to the eye drops which have some side effects.
A study of the acupuncture point GB37 suggests that acupuncture at GB37 can induce a complex
brain activity in the vision cortex.
A study which was done in 2015 found that acupuncture helped to improve retinitis
pigmetosa. This study found that the clinical effect of Erlong Xizhuʼs acupuncture was superior
to that of the conventional acupuncture for retinitis pigmentosa and was worth some promotion.
In my case, I was not able to find what Erlongʼs acupuncture was as the article was written in
Chinese and so I couldn’t understand.
Another study done in Switzerland found that there was some improvement in the visual
function of the patients who had inherited the retina diseases from acupuncture treatment. The
acupuncture protocol helped to improve the visual function of the patients who had inherited the
diseases of the retina and it was well-tolerated.
Nevertheless, the long-term effects of this main complementary therapy still remain to be
evaluated. Boel Acunova Acupuncture in Denmark claims that it’s leading the way in
opthmalogic acupuncture. John Boel, the founder of this school claims that more than 8000 eye
patients have received this treatment and the treatment has produced over 70% successful cases.
Dr. Boel published a pilot study project with ARMD Research. This pilot project had 27
ARMD patients who were split into three distinct groups. Different eye-specialists diagnosed
each of these patients who suffered from dry ARMD. The patients were given extensive
treatment over a period of four weeks using a new method of acupuncture referred to as the
acupuncture 2000 which is different from the Chinese acupuncture.
In the third test group, 60% of these patients experienced a 15.6% improvement in their
sight. In the second test group, 70% of the patients got a 28.5% improvement in their sight.
Finally, in the first test group, 80% of these patients got a 15-40% improvement in their sight.
The average improvement of the sight for all the three groups was 27%.
There is a great need to study the effects of acupuncture and Stargardt disease since we
don’t have any research data available in this area currently.
Chapter 3: Methods
The databases which were used in the research were PubMed, Medline, Embase, TCM, and
Google Scholar.
The main search terms in the research were acupuncture, Stargardt, vision, eyes, and eye disease.
When nothing was found for Stargardt treatment with acupuncture the search was expanded to
eye disease in general.
Articles on herbal remedies were excluded in this research as this is a review of the acupuncture
treatments available.
The search was kept to articles no older than 2013.
Chapter 4: References
Bittner, A. K., Gould, J. M., Rosenfarb, A., Rozanski, C., and Dagnelie, G. (2016). A pilot study
of an acupuncture protocol to improve visual function in retinitis pigmentosa patients.
Blechschmidt, T., Krumsiek, M., and Todorova, M. G. (2016). Improvement in Visual Function
in Patients with Inherited Diseases of the Retina Following Acupuncture Treatment. Department
of Ophthalmology. The University of Basel, Switzerland (Chairman a. i.: Prof. Selim Orgu
233(4):416-23. doi: 10.1055/s-0041-111819.
Boel. (n.d.). Research into ARMD (Age-Related Macular Degeneration).
Liu, J., Nan, J., Xiong, S., Li, G., Qin, W., and Tian, J. (2013). Additional evidence for the
sustained effect of acupuncture at the vision-related acupuncture point, GB37.
Blechschmidt, T., Krumsiek, M., and Todorova, M. G. (2017). Acupuncture benefits for
Flammer syndrome in individuals with inherited diseases of the retina.
Kim, T., Kang, J. W., Kim, K. H., Kang, K., Shin, M., Jung, S., Kim, A., Jung, H., Choi, J.,
Hong, K. U., Lee, S. D., and Choi, S. (n.d.). Acupuncture for the Treatment of Dry Eye: A
Multicenter Randomised Controlled Trial with Active Comparison Intervention (Artificial
Jiu, Z. Z. (July 2015). [Clinical observation of Erlong Xizhu acupuncture for retinitis
pigmentosa]: 681-684

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