This study evaluates the acute effects of cervical manual therapy on retinal and choroidal microvascular perfusion using optical coherence tomography angiography (OCTA). In this prospective randomized sham-controlled trial, 100 patients with chronic mechanical neck pain were randomly assigned to receive either cervical high-velocity low-amplitude manipulation combined with Maitland mobilization (manual therapy group) or sham treatment. Bilateral OCTA examinations were performed at baseline and at 15, 30, 60, and 120 minutes after intervention. The primary outcome is superficial capillary plexus (SCP) foveal vessel density. Secondary outcomes include deep capillary plexus (DCP) vessel density, radial peripapillary capillary (RPC) density, subfoveal choroidal thickness, foveal avascular zone parameters, retinal nerve fiber layer thickness, ganglion cell complex thickness, and macular thickness. The study aims to determine whether cervical manual therapy produces a significant augmentation of retinal and choroidal perfusion compared with sham treatment, with peak effects expected at 60 minutes post-intervention.
Who can participate
Age range
18 Years – 70 Years
Sex
ALL
See this in plain English?
AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.
Inclusion Criteria:
* Age 18-70 years
* Chronic mechanical neck pain lasting ≥3 months according to IASP criteria
* Baseline VAS pain score ≥3
* Absence of cervical radiculopathy or myelopathy
* Ability to provide informed consent and comply with study procedures
* Adequate ocular image quality for OCTA assessment
Exclusion Criteria:
* Previous cervical spine surgery or major cervical trauma
* Vertebrobasilar insufficiency or other contraindications to cervical manual therapy
* Active inflammatory rheumatic disease or systemic connective tissue disorder
* Known retinal or optic nerve disease that may affect OCTA measurements (glaucoma, diabetic retinopathy, age-related macular degeneration, optic neuritis, etc.)
* Diabetes mellitus with end-organ complications or uncontrolled systemic hypertension (\>160/100 mmHg)
* Refractive error \> ±6.0 D spherical equivalent or astigmatism \>3.0 D
* Intraocular pressure \>21 mmHg
* Previous ocular surgery, ocular trauma, or retinal laser treatment
* Media opacity preventing adequate OCTA image acquisition
* Pregnancy or lactation
* Participation in another interventional clinical study within the previous 30 days
Questions worth asking your doctor
Bring these to your next appointment. They're a starting point for a shared conversation — not a sign you qualify or a recommendation to enrol.
1Based on my diagnosis and history, is this trial worth exploring for me — or is there a standard treatment we should try first?
2What does this trial's phase tell us about how much is already known about its safety and benefit?
3What would taking part actually involve for me — visits, tests, time, and travel?
4What are the known and possible risks or side effects I should weigh, and how would they be monitored?
5If this trial isn't the right fit, what other options or trials would you suggest I look into?
Generated to help you prepare — always confirm anything about your own eligibility and care with the study team and your doctor.
Questions for the trial coordinator
The trial coordinator is the person who runs the study day to day. These cover the practical side — logistics, costs, and what taking part would actually mean for your life. The study team confirms whether you meet the criteria; these are questions to ask, not a sign you qualify.
1What does taking part actually involve week to week — how many visits, where, and how long does each one take?
2What costs are covered by the study, and what might I have to pay for myself, including travel, parking, or time off work?
3What happens during screening, and what happens if the study team confirms I don't meet the criteria after those tests?
4Who pays for the scans, blood work, and other tests the trial requires — the study, my insurance, or me?
5How will being in the trial affect my regular care, and will my own doctor stay informed and involved?
6Can I leave the trial at any point if I change my mind, and what would happen to my care if I do?
A starting point for the conversation — always confirm anything about your own eligibility, costs, and care with the study team and your doctor.
What they're measuring
1
Superficial Capillary Plexus (SCP) Foveal Vessel Density