Acupuncture for neuropathic pain in patients with dry eye disease: protocol for a systematic review and meta-analysis

Abstract Introduction Various randomized trials have demonstrated the therapeutic effect of acupuncture on the neuropathic pain (NP) in patients with dry eye disease (DED). However, the effectiveness and safety of acupuncture remain unclear. The objective of this systematic review is to assess the effectiveness and safety of acupuncture treatment related to NP in DED patients. Methods and analysis We will conduct searches across a range of databases including four English databases (PubMed, Cochrane Library, Embase, and Ovid), three Chinese databases (China National Knowledge Infrastructure, Wanfang, Chongqing VIP Information), three Japanese databases (Japan Agency for Science and Technology and Japan Medical Abstracts Service), as well as three Korean databases (Korean Medical Database, Oriental Medical Advanced Retrieval System, together with Research Information Service System) for papers published between January 2014 and October 2023. The search will not be restricted by language or publication date and focused solely on randomized controlled trials. Two researchers will independently perform data extraction, management, and analysis. Primary outcomes will consist of Schirmer's I test (SIT), tear breakup time (TBUT), ocular surface disease index scores (OSDI), neuropathic Pain Symptom Inventory modified for the Eye (NPSI-Eye), together with ocular pain assessment survey (OPAS). Secondary outcomes will consist of visual analogue scale (VAS) scores for ocular symptoms along with any acupuncture-related adverse events (AEs). Meta-analysis will be performed using Review Manager V.5.4. Meanwhile, the risk of bias will be independently evaluated utilizing the tool of "Risk of Bias" provided by Cochrane. Human Ethics and Consent to Participate declarations: not applicable. PROSPERO registration number CRD42023487570.