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Ophthal Plast Reconstr Surg. 2017 Jan 30. doi: 10.1097/IOP.0000000000000872. [Epub ahead of print]

Dilated Superior Ophthalmic Vein: Clinical and Radiographic Features of 113 Cases.

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1
*Department of Ophthalmology, SUNY Downstate Medical Center, Brooklyn, New York; †Ocular Oncology Service, Wills Eye Hospital, Philadelphia, Pennsylvania; ‡Department of Ophthalmology, Emory University Hospital, Atlanta, Georgia; §Texas Oculoplastic Consultants, Austin, Texas; ‖Department of Ophthalmology, Columbia University, Harkness Eye Institute, New York, New York;¶Department of Ophthalmology, Yale University School of Medicine, New Haven, Connecticut; #Department of Ophthalmology, UT Southwestern Medical Center, Dallas, Texas; **Department of Radiology, SUNY Downstate Medical Center, Brooklyn, New York; ††Carolina Ophthalmology, P.A., Hendersonville, North Carolina; ‡‡Oculofacial Plastic and Orbital Surgery, Oral and Maxillofacial Surgery, Flaum Eye Institute, University of Rochester, Rochester, New York; §§Department of Neurosurgery, Montefiore Medical Center, Albert Einstein University School of Medicine, Bronx, New York; and ‖‖Department of Neurology, ¶¶Department of Neurosurgery, ##Department of Neurology, and ***Department of Radiology, Hyman Newman Institute for Neurology and Neurosurgery, Center for Endovascular Surgery, Mt. Sinai-Roosevelt Hospital, New York, New York, U.S.A.

Abstract

PURPOSE:

Dilated superior ophthalmic vein (SOV) is an uncommon radiographic finding. The authors review the presentation, etiology, radiography, and visual implications of 113 patients with dilated SOV.

METHODS:

An observational case series and multicenter retrospective chart review were conducted. There were 113 patients with a dilated SOV. Outcome measures included patient demographics, clinical features, radiographic findings, diagnosis, and treatment, and treatment outcomes were assessed.

RESULTS:

Cases included 75 women (66%) and 38 men (34%) with a mean age of 49 ± 24 years (range, 0.4-90 years). Diagnoses fell under 6 categories: vascular malformation (n = 92, 81%), venous thrombosis (n = 11, 10%), inflammatory (n = 6, 5%), traumatic hemorrhage (n = 2, 2%), lymphoproliferative (n = 1, 1%), and infectious (n = 1, 1%). Imaging modalities utilized included MRI (n = 98, 87%), digital subtraction angiography (n = 77, 68%), CT (n = 29, 26%), and ultrasonography (n = 4, 4%). Disease status at last follow up included no evidence of disease (n = 57, 50%), alive with persistent disease (n = 53, 47%), and expired from disease (n = 3, 3%). Treatment and management was tailored to the underlying disease process with a mean follow up of 18 months (range, 1 day to 180 months). Visual impairment observed at presentation and last follow up across all cases was 26% and 22%, respectively.

CONCLUSION:

Dilated SOV is a rare radiographic finding resulting from a wide spectrum of etiologies with clinical implications ranging from benign to sight- and life-threatening. Dilated SOV is most often found with dural-cavernous fistula or carotid-cavernous fistula, orbital or facial arteriovenous malformation, and venous thrombosis. Recognition of this finding and management of the underlying condition is critical.

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