Clinical Efficacy of Stress-Free Therapy in Two Patients with Glaucoma

This is the authors' abstract. We don't add key points for this paper.

Introduction: Although acupuncture and moxibustion are complementary or alternative therapies for glaucoma, studies on their effectiveness reported in the Cochrane Database of Systematic Reviews are inconclusive. Stress-free (SF) therapy is a type of moxibustion therapy that targets acupuncture points and increases blood flow in the ocular fundus. This study aimed at evaluating the clinical efficacy of SF therapy in treating normal-tension glaucoma. Methods: In addition to visual field test (mean deviation [MD]) and visual acuity measurement, blood tests were performed to measure the following in a man aged 63 years and a woman aged 69 years with glaucoma without ophthalmic intervention and with mild cataract: triglycerides (TG), arteriosclerosis index (AI) determined as the low-density lipoprotein/high-density lipoprotein ratio, total lipids (TL), and estrogen (estradiol-2 [E-2]). SF therapy was performed by the patients themselves for 45 min daily for 4 weeks at a total of four points: Zusanli Point (ST36), Point F (the intersection between the 1st or 2nd toe line of the left sole and the medial/lateral malleolus line), Point N (the intersection between the vertical line of the right pupil and the middle line of the nasolabial fold), and Point P (the center of the closed left eyelid). Results and Discussion: In both patients after SF therapy, TG, AI, and TL levels were reduced, while E-2 levels were elevated. These changes may improve lipid metabolism and decrease vascular resistance, affecting ciliary-regulated circulation of the visual field. Elevated estrogen has a protective effect on the retinal ganglion cells and improves blood flow. Estrogen therapy after menopause is associated with a reduced incidence of glaucoma. Thus, in our patients, estrogen (E-2) levels elevating from 15.5 pg/mL at baseline to 22.5 pg/mL after SF therapy may have contributed to the improved visual function. Conclusion: SF therapy improved the visual acuity and visual field (MD score) in two patients with normal-tension glaucoma.