Digital ocular massage on intraocular pressure and Schlemm’s canal dimensions

Abstract

Purpose : Digital ocular massage has been advocated to reduce intraocular pressure (IOP) temporarily. This prospective observational study monitored Schlemm’s canal (SC) and trabecular meshwork (TM) dimensions using swept-source anterior segment optical coherence tomography (AS-OCT) to understand the mechanism of IOP reduction from ocular massage.

Methods : Forty-one healthy adults learned digital ocular massage by watching an educational video. After conducting baseline tonometry, area and length of the SC, TM length and thickness were measured using AS-OCT. Digital ocular massage was performed in the right eye for 10 minutes with the guidance of one examiner. Tonometry was performed immediately after ocular massage, followed by AS-OCT of the SC and TM. IOP was measured again 5 minutes after ocular massage. Outcome measures were IOP, SC area and diameter, TM width and thickness. Results are presented as mean +/- standard deviation or median (interquartile range) for data normally distributed or not, respectively.

Results : All subjects demonstrated IOP reduction after ocular massage (pre: 15.2±2.7 mmHg; post-immediate: 9.0±2.0 mmHg; post-5-minute: 10.3 (3.6) mmHg; generalized estimating equations: df = 2, p < 0.01). SC area was significantly larger after ocular massage (pre: 9516.0 (4448.1) µm²; post: 10160.1 (7411.4) µm²; Wilcoxon test, p = 0.009). There was no significant change in SC length (pre: 275.0±90.4 µm; post: 278.2±66.6 µm; paired t-test, t = -0.206, p = 0.838), TM length (pre: 740.1±85.0 µm; post: 735.5±88.4 µm; paired t-test, t = 0.497, p = 0.622), and TM thickness pre: 145.8 (34.3) µm; post: 139.6 (28.9) µm; Wilcoxon test, p = 0.197). Eyes with a higher baseline IOP demonstrated a greater IOP reduction (Pearson correlation coefficient r = -0.68, p < 0.01), Figure 1. There was a significant association between IOP reduction and relative change in SC area (Pearson correlation coefficient r = -0.365, p = 0.019), Figure 2.

Conclusions : Digital ocular massage is an effective way to lower IOP. The expansion of SC area was positively associated with IOP reduction.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.

 

Figure 1. Correlation between intraocular pressure (IOP) change with baseline IOP. Solid line is the regression line. Dotted lines are 95% confidence intervals.

 

Figure 2. Correlation between intraocular pressure (IOP) change and relative change in Schlemm’s canal (SC) area. Solid line is the regression line. Dotted lines are 95% confidence intervals.