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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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*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.



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.


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.


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.


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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