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.