{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T04:56:47Z","timestamp":1781672207887,"version":"3.54.5"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Ophthalmol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This paper presents a case of periorbital venous malformation treated using appropriate Traditional Chinese Medicine interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>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\u00d71.28 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\u2019s 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fopht.2026.1787288","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T04:44:50Z","timestamp":1781671490000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["The traditional Chinese medicine bloodletting therapy at the Taiyang acupoint (No.EX-HN5) for the treatment of periorbital venous malformation: a case report"],"prefix":"10.3389","volume":"6","author":[{"given":"Yanli","family":"Zhang","sequence":"first","affiliation":[{"name":"Ningbo Key Laboratory of Medical Research on Blinding Eye Diseases, Ningbo Eye Institute, Ningbo Eye Hospital, Wenzhou Medical University","place":["Ningbo, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyun","family":"Cao","sequence":"additional","affiliation":[{"name":"Ningbo Key Laboratory of Medical Research on Blinding Eye Diseases, Ningbo Eye Institute, Ningbo Eye Hospital, Wenzhou Medical University","place":["Ningbo, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunhong","family":"Chen","sequence":"additional","affiliation":[{"name":"Ningbo Key Laboratory of Medical Research on Blinding Eye Diseases, Ningbo Eye Institute, Ningbo Eye Hospital, Wenzhou Medical University","place":["Ningbo, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zengfang","family":"Yu","sequence":"additional","affiliation":[{"name":"Ningbo Key Laboratory of Medical Research on Blinding Eye Diseases, Ningbo Eye Institute, Ningbo Eye Hospital, Wenzhou Medical University","place":["Ningbo, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Li","sequence":"additional","affiliation":[{"name":"Ningbo Key Laboratory of Medical Research on Blinding Eye Diseases, Ningbo Eye Institute, Ningbo Eye Hospital, Wenzhou Medical University","place":["Ningbo, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaoqun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Ningbo Key Laboratory of Medical Research on Blinding Eye Diseases, Ningbo Eye Institute, Ningbo Eye Hospital, Wenzhou Medical University","place":["Ningbo, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Man","family":"Kang","sequence":"additional","affiliation":[{"name":"Ningbo Key Laboratory of Medical Research on Blinding Eye Diseases, Ningbo Eye Institute, Ningbo Eye Hospital, Wenzhou Medical University","place":["Ningbo, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anndiagpath.2005.07.008","article-title":"Vascular tumors in the orbit--capillary and cavernous VMs","volume":"10","author":"Rosca","year":"2006","journal-title":"Ann Diagn Pathol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1035472","article-title":"Les tumeurs vasculaires de l'orbite [Vascular tumors of the orbit","volume":"206","author":"Ducrey","year":"1995","journal-title":"Klin Monbl Augenheilkd"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000022495","article-title":"Diagnosis of multiple pulmonary cavernous VMs via dual-layer spectral CT: A case report","volume":"99","author":"Bae","year":"2020","journal-title":"Med (Baltimore)"},{"key":"B4","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1038\/s41698-019-0099-9","article-title":"Propranolol exhibits activity against VMs independent of beta blockade","volume":"3","author":"Sasaki","year":"2019","journal-title":"NPJ Precis Oncol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/5695378","article-title":"Proanthocyanidins as a potential novel way for the treatment of VM","volume":"2021","author":"Tang","year":"2021","journal-title":"BioMed Res Int"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1055\/s-0041-1732948","article-title":"Cavernous VM in the orbital cavity. the orbital cavity: Case report","volume":"16","author":"Almeida","year":"2022","journal-title":"Eur J Dent"},{"key":"B7","doi-asserted-by":"publisher","first-page":"11016","DOI":"10.1038\/s41598-021-90419-9","article-title":"CT definition of the surgical apex in the orbit","volume":"11","author":"Zurinam","year":"2021","journal-title":"Sci Rep"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.58062","article-title":"Successful management of a large orbital VM in an infant: A case report","volume":"16","author":"Abdulla","year":"2024","journal-title":"Cureus"},{"key":"B9","doi-asserted-by":"publisher","first-page":"863","DOI":"10.1038\/s41598-020-57681-9","article-title":"Predictive factors of postoperative infection-related complications in adult patients with cerebral cavernous malformations","volume":"10","author":"Ding","year":"2020","journal-title":"Sci Rep"},{"key":"B10","doi-asserted-by":"publisher","first-page":"133","DOI":"10.3892\/mco.2022.2566","article-title":"Overexpression of Annexin A1 is associated with the formation of capillaries in infantile VM","volume":"17","author":"Pan","year":"2022","journal-title":"Mol Clin Oncol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2020.110157","article-title":"Diagnosis and treatment of periorbital infantile VMs: case series and literature review","volume":"136","author":"Sun","year":"2020","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S153121","article-title":"Combined oral propranolol with intralesional injection of triamcinolone acetonide in treatment of infantile periocular VMs. VMs","volume":"11","author":"Alsmman","year":"2017","journal-title":"Clin Ophthalmol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1097\/DSS.0000000000003491","article-title":"Clinical outcomes of small infantile VMs treated with pulsed dye laser","volume":"48","author":"Nakazono","year":"2022","journal-title":"Dermatol Surg"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1089\/fpsam.2023.0012","article-title":"Advantages of early surgical management of periorbital infantile VMs","volume":"26","author":"Chan","year":"2024","journal-title":"Facial Plast Surg Aesthet Med"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1177\/20503121211056844","article-title":"Treatment patterns and outcomes in children with infantile VMs: A retrospective observational analysis","volume":"9","author":"Cai","year":"2021","journal-title":"SAGE Open Med"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-024-04723-1","article-title":"Gamma knife radiosurgery for orbital cavernous VM: a systematic review and single-arm meta-analysis. review and single-arm meta-analysis","volume":"169","author":"Punukollu","year":"2024","journal-title":"J Neuro-Oncol"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1177\/2058460117728416","article-title":"VM of the rib showing a relatively high 18F-FDG uptake: a case report with a literature review. report with a literature review","volume":"6","author":"Itabashi","year":"2017","journal-title":"Acta Radiol Open"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12175703","article-title":"The natural history and management of hepatic VM","volume":"12","author":"Maruyama","year":"2023","journal-title":"J Clin Med"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.14033\/j.cnki.cfmr.2023.04.043","article-title":"Progress of interventional therapy for hepatic VM and discussion on Chinese medicine","volume":"21","author":"Chen","year":"2023","journal-title":"Chin Foreign Med Res"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.16305\/j.1007-1334.1979.06.006","article-title":"Observation on the therapeutic effect of 33 cases of cavernous VM treated by traditional Chinese medicine","author":"Xia","year":"1979","journal-title":"Shanghai J Traditional Chin Med"},{"key":"B21","article-title":"A case of cavernous VM combined with intratumoral hemorrhage and subarachnoid hemorrhage with epilepsy treated by Xiao Chaihu Tang combined with Peach Kernel Cheng Qi Tang with flavor","volume":"15","author":"You","year":"2022","journal-title":"Global Chin Med"},{"key":"B22","article-title":"A case of giant VM of the liver treated by Lei Ling applying the method of dredging the liver and strengthening the spleen to dispel blood stasis and resolve phlegm","volume":"32","author":"Lei","year":"2022","journal-title":"J Liver Dis Chin Western Med"},{"key":"B23","article-title":"Research and therapeutic effect analysis of Chinese traditional medicine by expelling blood stasis and eliminating tumors in the treatment of interosseous VM of the limbs","volume":"2","author":"Yang","year":"2012","journal-title":"Chin Med Sci"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.13457\/j.cnki.jncm.2022.20.033","article-title":"Clinical study on the treatment of solid headache by bloodletting at Taiyang acupoint combined with acupuncture","volume":"54","author":"Dong","year":"2022","journal-title":"New Chin Med"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.16808\/j.cnki.issn1003-7705.2024.01.040","article-title":"Overview of clinical application of Taiyang acupoint","volume":"40","author":"Hu","year":"2024","journal-title":"Hunan J Traditional Chin Med"},{"key":"B26","volume-title":"Clinical Efficacy Observation of Acupuncture Therapy for Regulating Qi and Relieving Pain Combined with Bloodletting in the Treatment of Tension-Type Headache","author":"Liu","year":"2023"},{"key":"B27","article-title":"Efficacy of bloodletting at the Taiyang acupoint combined with hot compresses in the treatment of blepharitis and its effect on the degree of pain","volume":"9","author":"Wang","year":"2025","journal-title":"Modern Med Health Res Electronic J"},{"key":"B28","article-title":"Observation on clinical efficacy of bloodletting from ear tip and Taiyang acupoint for the treatment of eye redness and swelling pain","volume":"7","author":"Yu","year":"2015","journal-title":"Chin Med Clin Res"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.19621\/j.cnki.11-3555\/r.2006.02.016","article-title":"Acupuncture and bloodletting at Taiyang acupoint for the treatment of 68 cases of early granuloma","author":"Chen","year":"2006","journal-title":"Chin Folk Ther"},{"key":"B30","doi-asserted-by":"publisher","first-page":"18","DOI":"10.19621\/j.cnki.11-3555\/r.2004.02.021","article-title":"Treatment of acute conjunctivitis with acupuncture and bloodletting at Taiyang acupoint in 22 cases","author":"Zhu","year":"2004","journal-title":"Chin Folk Ther"},{"key":"B31","doi-asserted-by":"publisher","first-page":"5","DOI":"10.3760\/cma.j.issn.0376-2491.2009.44.009","article-title":"Short-term efficacy and safety evaluation of low-dose oral propranolol in treating infantile VM","volume":"89","author":"Qin","year":"2009","journal-title":"Chin Med J"},{"key":"B32","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3969\/j.issn.1674-1293.2008.02.031","article-title":"Conservative vs. surgical management of moderately sized infantile VMs of the neck","author":"Xia","year":"2008","journal-title":"J Pract Dermatol"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.3877\/cma.j.issn.2095-5782.2020.03.005","article-title":"Clinical observation on interventional sclerotherapy embolization for orbital vascular malformations","volume":"8","author":"Jiang","year":"2020","journal-title":"Chin J Interventional Radiol (Electronic Edition)"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-41854-0_3","article-title":"Clinical study of transcranial magnetic stimulation combined with bloodletting at twelve well points for the treatment of limb dysfunction in patients with acute ischemic stroke","volume":"40","author":"Guo","year":"2025","journal-title":"China Rehabil"},{"key":"B35","article-title":"Nursing care for a case of pulmonary lymphangioleiomyomatosis complicated by polycythemia treated with phlebotomy","volume":"7","author":"Liu","year":"2010","journal-title":"Nurs Pract Res"},{"key":"B36","volume-title":"Clinical Research on the Treatment of Stasis-Type Lumbar Spondylotic Syndrome by Combining White Tiger Shaking Therapy with Bloodletting Therapy","author":"Liu","year":"2014"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1003-5699.2008.06.049","article-title":"Theory and application of bloodletting by stabbing the collaterals of the Internal Canon","volume":"28","author":"Chen","year":"2008","journal-title":"Jilin Chin Med"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.14033\/j.cnki.cfmr.2025.10.039","article-title":"The application of stabbing and bloodletting therapy combined with the twelve methods of guided life-supporting gong in patients with vertebral artery-type cervical spondylosis","volume":"23","author":"Zhang","year":"2025","journal-title":"Chin Foreign Med Res"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.19621\/j.cnki.11-3555\/r.2025.1220","article-title":"Clinical observation of intradermal needle combined with fingertip bloodletting therapy in the treatment of patients with cerebral hemorrhage in the acute stage with hypertensive disease","volume":"33","author":"Deng","year":"2025","journal-title":"Chin Folk Ther"},{"key":"B40","doi-asserted-by":"publisher","first-page":"78","DOI":"10.13424\/j.cnki.jsctcm.2019.02.023","article-title":"Study on the difference between bloodletting therapy of Chinese medicine and Mongolian medicine","volume":"42","author":"Wu","year":"2019","journal-title":"J Shaanxi Univ Traditional Chin Med"},{"key":"B41","first-page":"3","article-title":"Application of traditional Chinese medicine bloodletting therapy in preventive medicine","volume":"35","author":"Fu","year":"2020","journal-title":"J Chin Med Pharm"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1674-1749.2023.12.035","article-title":"Combined treatment with qi-tonifying and meridian-unblocking formula and acupuncture bloodletting for 42 cases of qi deficiency and blood stasis pattern in diabetic peripheral vascular disease of the lower extremities","volume":"16","author":"An","year":"2023","journal-title":"Global J Traditional Chin Med"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000024203","article-title":"Clinical efficacy of Mongolian acupuncture bloodletting combined with Shujing Tuina in treating lumbar disc herniation","author":"Zhang","year":"2022","journal-title":"J Chin Ethnic Med"},{"key":"B44","unstructured":"Standardized manipulations of acupuncture and moxibustion\u2014Part 3: ear acupuncture\n          \n          \n          \n          2021"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1016\/s0039-6257(96)82001-7","article-title":"Color Doppler ultrasound imaging of the eye and orbit","volume":"40","author":"Williamson","year":"1996","journal-title":"Surv Ophthalmol"}],"container-title":["Frontiers in Ophthalmology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fopht.2026.1787288\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T04:45:13Z","timestamp":1781671513000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fopht.2026.1787288\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,17]]},"references-count":45,"alternative-id":["10.3389\/fopht.2026.1787288"],"URL":"https:\/\/doi.org\/10.3389\/fopht.2026.1787288","relation":{},"ISSN":["2674-0826"],"issn-type":[{"value":"2674-0826","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,17]]},"article-number":"1787288"}}