By Shandong Science And Technology Press (1985)
Retinopathy is common fundus disease in clinic, which is difficult to treat. It includes central retinitis, centro-retino-choroiditis, retinal central vein occlusion, retinal arterial occlusion, retinal hemorrhage and retinal arteriosclerosis.
Symptoms and Signs:
Those diseases occur more in adult males. Patient may suffer from a varying degree of decreasing visual acuity and metamorphopsia.In case of retinal arterial occlusion, the patient may suddenly lose his visual acuity completely or partially. If it is not treated in time, vision may be severely impaired.
A Points: there are two groups of points used:
Group 1. Jingming, Yiming, Yangbai Guangming;
Group 2. Qiuhou, Taiyang, Fengchi, Xingjian.
B Procedure: two groups of points used alternately in courses of treatment. Manipulations for Jingming, same as in acute conjunctivitis, and those for Yiming penetrate perpendicularly 0.5 ~ 1 inch with twirling. In Yangbai needle is directed toward the Yuyao with twirling and scraping the needle. Penetrate Guangming toward the contraside with 1 ~ 1.5 inch deep and twirling the needle.
During puncturing Qiuhou, let patient look forward, the physician takes the needle as holding a writing brush and penetrates along the lower border of the orbit perpendicularly with 1 ~ 1.5 inch.
It should be noticed that if insertion of the needle must be slow after the needle has passed subcutaneous tissue, then lifting and scraping the needle slowly. In puncture of Taiyang, the needle is at a 450 angle and toward the Xiaguan with depth of 1 ~ 1.2 inch and then thrusting, lifting and scraping the needle. The method used for Fengchi is the same as in acute conjunctivitis.
Xiangjian is penetrated perpendicularly 0.3 ~ 0.6 inch and twirling method is used.
Retaining of needles in above points are 15 ~ 30 minutes. Once manipulation is given for every 5 ~ 10 minutes. Remedy is given once every day. Seven treatments are therapeutic course and are given with interval of 2 ~ 3 days between the course.
The treatment described above is indicative for central retinitis.
C Case Examples:
Case 1. Wang, male 34 years old, Jun 13, 1975 O.P.D. patient.
Vision much impaired suddenly for 3 days, headache and vertigo associated. Ophthalmologic examination performed in other hospital the results are: Swelling of macular region of fundus ++, severe cloudiness, no reflex seen in the disc. Visual acuity O.S. 0.3, O.D. 1.5. Diagnosis was central retinitis. Patient was treated with both modern and Chinese traditional medicines but no improvement obtained. Acupuncture therapy thus acquired.
In author’s O.P.D. patient was treated with remedy 1 with retaining of needle 30 minutes. Puncture is given once daily. Patient’s visual acuity markedly improved after 3 times of acupuncture, O.S. increased to 0.6, vertigo and headache much diminished also.
Group 2 points were used in the second therapeutic course with acupuncture once daily. On Jun 29, patient’s vision increased to 1.2, swelling of macula region all lost. Central macula reflex presented but the color discrimination still not quite definite.
Therapeutic effect still presents in after half year.
Case 2. Oct. 10, 1977, O.P.D. patient Liu, male, 37 years age, a worker.
Metamorphosis, micropsie and diminution in acuteness of vision occurred rapidly since recent 8 months. Diagnosis given in other hospitals is central retinitis. Patient was hospitalized for more than 6 months there, various treatments received, but the visual acuity still diminished progressively and had decreased to 0.04 O.U.
Visual acuity just before acupuncture was 0.1. Acupuncture was given as above, two groups of points were adapted alternately for each therapeutic course.
The interval between treatment courses was 3 days. Vision acuity increased to 0.5 after 3 punctures and increased to 0.7 after one course of treatment. Flashing lights sensation diminished, central dark spot in the fundus reduced.
Vision acuity increased to 0.8, metamorphosia lost after second treatment. Vision acuity remained 0.8 in third course of therapy, and the treatment discontinued since then.
Acuteness of vision remained 0.8 in after one year.
A Points: Jingming, Hegu
B Procedure: At first, puncture left Jingming slowly with depth about 1 inch. Scraping the needle, patient may feel numbness sensation in fundus of eye and lateral canthus during acupuncture. Lacrimation may also present.
The next step is to puncture right Jingming with same method as in left side.
Puncture Hegu and twirl the needle.
Retaining of needles for above point are 15 ~ 30 minutes in duration.
Puncture given once daily with manipulation once every 15 ~ 30 minutes.
This method of treatment is prevalent on central retinal arterial occlusion.
C Case example:
Sept. 20, 1970, O.P.D. patient Yin, female, 28 years of age, a staff.
Vision O.S. lost suddenly 3 days ago. Ophthatmological examination performed in a hospital: Vision acuity O.D. 0.8, light sensation O.S. Dilation of right pupil with dullness to direct light reflex. Macula appears cherry red. Retinal artery became narrow as a thread. Optic disc whitish with indefinite border.
Diagnosis: Central retinal arterial occlusion
Patient was treated as above with retaining needle 30 minutes. Manipulated the needle once every 10 minutes. Remedy was given once every day. Patient’s vision was improved to 0.5 after treatment, and 3 remedies were given totally. Then the patient’s vision acuity increased to 1.0 after the treatments.
A Points: Fengchi, Luxi, Jiaosun, Dazhui, Ganshu, Shenshu, Jingming, Taiyang, Yangbai, Yuyao, Zanzhu, Gaohuang
B Procedure: for making brain to be clear and eyes to be good in vision and relieving the blood stasis, Fengchi, Luxi, Jiaosun, Dazhui, Ganshu and Shenshu are adapted with manipulation for inducing heat sensation.
In the point of Jingming, insertion of needle should be gentle.
For Taiyang, Yangbai, Yuyao, and Zanzhu, ordinary methods are adapted.
In order to regulate the function of liver and tranquilization, invigorate the kidney to strengthen the body, Gaohuang, Ganshu, Shenshu are adapted for inducing heat sensation but not retaining the needle.
For other symptoms, associated points may be selected (Zheng Yulin: J. Chinese Traditional Med. 1957. 6).
Remedy used for 41 cases by author, the results were 12 cases radically cured; 6 cases markedly improved; 19 cases slightly improved; 4 cases no effect.
Retinopathy belongs to “Nei Zhang” in Chinese traditional medicine, which is very similar to eye diseases such as “Shi Zhan Hun Miao”, “Bao Mang” or “Shi Huo” etc. The pathogenesis is very complicated. Over fatigue, depression of liver-energy, dryness of fire and wind, deficiency of kidney function, congenital deficiency, acquired malnutrition etc. may cause this disease.
It was considered that “Nei Zhang” usually belongs to Xu in nature, the treatment of this disease according to the deficiency of blood and asthenia of kidney and liver is not very reasonable. Points in acupuncture therapy should be selected symptomatically.
The points in local area for treating retinopathy are Jingming, Qiuhou, Yangbai, Taiyang.
Point Qiuhou locates near the ciliary ganglion and ciliary nerve, which supplies the eyes. Puncture of Qiuhou is very effective in treating retinopathy directly.
“Exploration to Formations of Internal Organs” described: “Channels all belong to the eyes”. So, eye diseases are the reaction of pathological change of internal organs. Therefore, in treating eye diseases not only select the local points near the eye, such as Yiming and Fengchi, but also the points away from the eyes, such as Hegu, Guangming, Xingjian. Thus balance of various portions of whole body may be resulted and the cure of fundus diseases may also be successful.
Duration of treating retinopathy is usually long. The manipulation of needle is still under discussion. Author suggested that method of manipulation in acupuncture may be various in different patients. Physician Yang Ji Zhou said: “ The methods of treating disease are various with persons but do not depend upon the number of treatments given. Variations of treating methods depend upon the kind of disease but not the remedy used.”
It has been proved that acupuncture is very effective to fundus diseases, improvement of visual acuity usually obtained by first treatment and get better progressively after each remedy. There was a case, patient Xu suffered from retinochoroiditis with loss of vision for 8 years, improvement was gotten after first acupuncture and even better after 7 times of treatment.