Ocular massage in central retinal artery occlusion: Monitoring vascular recovery with optical coherence tomography angiography - A case series.

PURPOSE: Central Retinal Artery Occlusion (CRAO) is an ophthalmic emergency with a generally poor visual prognosis. Currently, no universally effective, evidence-based treatment exists, and therapeutic options remain limited. Ocular massage (OM) has been proposed as a potential intervention aimed at dislodging emboli and improving retinal perfusion. Optical Coherence Tomography Angiography (OCTA) is emerging as a valuable imaging tool for assessing retinal microvascular changes in real-time. This study evaluates the role of OM in CRAO management and highlights the utility of OCTA in monitoring vascular response.

METHODS

We present a case series of three patients diagnosed with CRAO who underwent prolonged OM. OCTA was performed before, during, and after treatment to assess changes in retinal capillary plexus perfusion. Visual acuity (VA) and structural OCT findings were also recorded.

RESULTS

OM led to significant improvements in VA and retinal perfusion in all cases. OCTA revealed progressive increases in vessel density within both the superficial and deep capillary plexuses during OM, correlating with clinical recovery. One case of transient retinal artery occlusion (TRAO) demonstrated no apparent structural changes on fundus examination or OCT, but OCTA successfully identified early microvascular alterations, enabling prompt diagnosis and intervention.

CONCLUSIONS

OM appears to promote retinal reperfusion in CRAO, suggesting a potential therapeutic benefit. OCTA proves to be a crucial non-invasive tool for detecting vascular alterations that may not be visible with conventional imaging. Further studies are required to validate these findings and refine CRAO management strategies.