Acupuncture combined with Tuina therapy for the treatment of anisometropic amblyopia and track visual cortex activation status: A case report

Rationale: Amblyopia is a common pediatric neurodevelopmental disorder of vision, necessitating early intervention to improve visual acuity. We report a case of a child with anisometropic amblyopic whose best corrected visual acuity of the right eye (OD, amblyopic eye) remained stable at 0.6 LogMAR despite 10 months of conventional occlusion therapy. We further evaluated the therapy’s efficacy using functional near-infrared spectroscopy (fNIRS) to monitor visual cortex activation. Patient concerns: A 6-year-old boy with anisometropic amblyopia came to seek Chinese medicine treatment in June 2020. Before 2020, the child had undergone 2 years of binocular optical correction and relatively good occlusion treatment. After a 10-month period of visual plateau (BCVA stable at 0.6 LogMAR) despite conventional treatment, we tried the treatment of acupuncture combined with Tuina therapy. Diagnoses: A case of anisometropic amblyopia refractory to conventional occlusion therapy. Interventions: The patient received acupuncture combined with Tuina therapy (Chinese therapeutic massage). Outcomes: After 10 sessions of acupuncture combined with Tuina therapy, the OD best corrected visual acuity improved to 0.2 LogMAR, representing a 0.4 LogMAR gain. Lessons: Acupuncture combined with Tuina therapy was associated with improved visual acuity in this single-case of amblyopia, suggesting potential as a new treatment approach for those who exhibit poor compliance or inadequate response to traditional therapies. However, as a case report, these findings are preliminary and require validation in larger controlled studies. Additionally, the study proposes that fNIRS can serve as a convenient and effective technique for monitoring the impact of acupuncture and Tuina on the visual cortex, providing an evaluation metric for future integrated eye-brain treatments.