The traditional Chinese medicine bloodletting therapy at the Taiyang acupoint (No.EX-HN5) for the treatment of periorbital venous malformation: a case report.

Background: This paper presents a case of periorbital venous malformation treated using appropriate Traditional Chinese Medicine interventions. Case presentation: A 27-year-old Asian Han female presented with prominent swelling of the right periorbital region that appeared when looking downward, accompanied by greenish skin discoloration, which resolved upon elevating the head. Initially, the patient did not seek medical attention, attributing the symptoms to fatigue and insufficient rest. However, the swelling recurred upon awakening, prompting the patient to seek medical evaluation at a hospital. Ocular ultrasound and orbital computed tomography (CT) were subsequently performed, resulting in a diagnosis of periorbital VM. Ocular ultrasound revealed the VM measured 2.0×1.28 cm. Additional ophthalmological findings were as follows: intraocular pressure-OD 14 mmHg, OS 16 mmHg; refraction-OD 0.00/-0.25, OS -1.00/-0.25; visual acuity-OD 1.0, OS 0.8. The patient was subsequently referred to the Departments of Traditional Chinese Medicine (TCM) and Ophthalmology, where management was overseen by a TCM ophthalmologist. The physician recommended bloodletting at the ear tips or Taiyang acupoints as part of the treatment and instructed the patient to adhere to this regimen for monitoring and further management. The patient complied with the physician's instructions, undergoing Taiyang acupoint bloodletting once weekly, with approximately 2 mL of blood removed per session. Six months later, follow-up ocular ultrasound demonstrated a reduction in VM size, although minor changes could be attributable to measurement variability. No evidence of lesion growth was observed, prompting further follow-up evaluations. The patient was instructed to abstain from meridian-based Taiyang acupoint bloodletting for two weeks. Serial ocular ultrasound examinations were performed to assess VM size and peripheral blood flow at multiple time points: pre-bloodletting, immediately post-procedure, and at 1, 2, 5, 7, 24 hours, and 3, 7, 12, and 14 days following the intervention. The results indicated the clinical efficacy of combined Chinese and Western interventions, including Taiyang acupoint meridian stabbing and bloodletting therapy, in managing periorbital VM. Conclusion: Taiyang acupoint meridian bloodletting therapy, when applied to a localized periorbital VM, may exert a therapeutic effect. The therapy temporarily reduces blood flow to the VM, alleviates swelling, improves patient comfort, and mitigates tissue compression associated with the lesion. However, this case report focuses exclusively on a localized periorbital VM during follow-up assessment and is intended solely for clinical reference. Medical guidance should be followed for the targeted and comprehensive management of VM.