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)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
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
ABSTRACT
Background:
Primary Open-Angle Glaucoma (POAG) and Ocular Hypertension (OHT) are major causes of irreversible blindness globally, with a significant disease burden in India. Conventional treatments primarily aim at reducing intraocular pressure (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:
A comprehensive search will be conducted in 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 search will cover clinical trials, including randomized controlled trials (RCTs), controlled clinical trials (CCTs), observational studies, and single-arm trials. 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. Clinical Trial: PROSPERO 2024 CRD42024592392 https://www.crd.york.ac.uk/PROSPERO/view/CRD42024592392
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