Superior ophthalmic vein thrombosis
Superior ophthalmic vein thrombosis is rare but can potentially lead to visual loss in the affected eye(s).
Epidemiology
Superior ophthalmic vein thrombosis is very rare, with an incidence of 3-4 cases/million/year . It can be either unilateral or bilateral.
Clinical presentation
Superior ophthalmic vein thrombosis may manifest as :
- painful proptosis
- conjunctival congestion
- chemosis
- ophthalmoplegia
- visual disturbance which can progress to loss of vision
Complications are usually due to the underlying pathology .
Pathology
Etiologies can be divided into septic and aseptic :
- septic etiologies
- orbital cellulitis - most common cause
- paranasal sinusitis
- septic cavernous sinus thrombosis
- aseptic etiologies
- facial trauma
- aseptic facial inflammation
- caroticocavernous fistula
- hypercoagulable states
- orbital neoplasm
- idiopathic orbital inflammation
- Tolosa-Hunt syndrome
Radiographic features
The modalities of choice for the diagnosis of superior ophthalmic vein thrombosis are CT venography (CTV) and MR venography (MRV). The thrombus is visualized as a linear filling defect that dilates the vein and can extend into the ipsilateral cavernous sinus (if its origin was not the cavernous sinus, to begin with).
Treatment and prognosis
Immediate anticoagulant treatment should be instituted, as well as treatment for the underlying cause where applicable.
Siehe auch:
Assoziationen und Differentialdiagnosen zu Thrombose der Vena ophthalmica superior:
