Previously submitted to: JMIR Research Protocols (no longer under consideration since Mar 18, 2026)
Date Submitted: Mar 20, 2025
Open Peer Review Period: Mar 21, 2025 - May 16, 2025
(closed for review but you can still tweet)
Efficacy and safety of Ayurveda interventions for Primary Open-Angle Glaucoma and Ocular Hypertension in India over the last 40 years: A Systematic Review and Meta-Analysis Protocol
Background:
Primary Open-Angle Glaucoma (POAG) is a major cause of irreversible blindness globally, with a significant disease burden in India. When intraocular pressure (IOP) is raised in the absence of glaucomatous damage, the condition is termed ocular hypertension (OHT), a recognised risk factor for development of POAG. Conventional treatments primarily aim at reducing IOP through pharmacological agents, laser therapy, and surgery, but these approaches are often limited by side effects, poor adherence, and disease progression despite optimal IOP control. Ayurveda, the traditional medical system of India, offers therapeutic interventions such as Kriyakalpa (specialized ocular procedures), Panchakarma (purificatory therapies), and herbal or herbo-mineral formulations that may provide a neuroprotective and IOP-lowering effect in POAG and OHT. However, the clinical evidence supporting the efficacy and safety of these interventions remains fragmented and inconsistent.
Objective:
This systematic review and meta-analysis aim to evaluate and synthesize evidence on the efficacy and safety of Ayurveda interventions for the management of POAG and OHT in various institutes of India over the last 40 years (1984–2024).
Methods:
Randomized controlled trials, non-randomized controlled trials, observational cohort or case-control studies, and single-arm intervention series published between 1984 and 2024 will be identified through a comprehensive search of electronic databases, including Cochrane Complementary Medicine Trial Register, Annotated Bibliography of Indian Medicine, Web of Science, MEDLINE via PubMed, PubMed Central, Cochrane Central Register of Controlled Trials, National Institute of Science Communication and Information Resources, Scopus, EMBASE, Directory of Open Access Journals, Google Scholar, and Digital Helpline for Ayurveda Research Abstracts. The primary outcome measures will include reduction in IOP, visual field progression, and optic nerve head health. Secondary outcomes will include adverse events associated with Ayurveda interventions. Risk of bias will be assessed using the Cochrane Risk of Bias (RoB 2) tool for RCTs and the Risk of Bias in Non-Randomized Studies of Interventions (ROBINS-I) tool for non-randomized studies. A random-effects model will be used for quantitative synthesis, and a narrative synthesis will be conducted for heterogeneous data.
Results:
Protocol is developed. Since this is a systematic review protocol, no definitive results are available at this stage.
Conclusions:
This systematic review will provide comprehensive insights into the role of Ayurveda in managing POAG and OHT, including its therapeutic efficacy and safety. The findings will contribute to the development of clinical guidelines and inform future research on integrative approaches in glaucoma management.
ClinicalTrial:
Systematic review registration number: PROSPERO CRD42024592392 https://www.crd.york.ac.uk/PROSPERO/view/CRD42024592392
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.