Impact of superior ophthalmic vein thrombosis: a case series and literature review

Orbit. 2019 Jun;38(3):226-232. doi: 10.1080/01676830.2018.1497068. Epub 2018 Jul 24.

Abstract

Purpose: To present nine new cases of superior ophthalmic vein thrombosis (SOVT) and compare these with the literature, and to assess the impact of SOVT for the clinician. Methods: Using the data bases of the Department of Ophthalmology of the AMC, we searched for patients with radiologically evidenced SOVT between January 2006 and December 2014. In addition, a PubMed search, using the mesh term 'superior ophthalmic vein thrombosis', was done. Results: We found nine patients with SOVT. In three patients, SOVT was related to dural arteriovenous fistulae. In one patient, it was caused by the acute reversal of warfarin by vitamin K. In two patients, an infectious cause was found. In three patients, the cause of SOVT was not found despite screening for coagulation and other disorders. All patients presented with eyelid swelling, proptosis, and/or motility impairment. We found complete recovery in four patients. Three patients had mild sequelae and two patients had severe visual impairment. In the literature, we found 60 cases reporting on SOVT with various aetiologies. Clinical presentation, treatment modalities, and outcomes were comparable to our findings. Conclusion: Our case series and literature review show that SOVT can occur simultaneously with cavernous sinus thrombosis (CST) but can also be a separate entity. Clinical presentation can mimic orbital cellulitis (OC) or CST and when no signs of OC can be found, an alternative cause for SOVT should be sought. When timely and adequate treatment is conducted, the prognosis is predominantly favourable.

Keywords: Arteriovenous fistula; cavernous sinus thrombosis; orbital cellulitis; superior ophthalmic vein thrombosis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Blepharoptosis / diagnosis
  • Cavernous Sinus Thrombosis / complications
  • Cavernous Sinus Thrombosis / diagnostic imaging
  • Central Nervous System Vascular Malformations / complications
  • Central Nervous System Vascular Malformations / diagnostic imaging
  • Exophthalmos / diagnosis
  • Eye / blood supply*
  • Eye Infections / complications
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Ophthalmologic Surgical Procedures
  • Orbital Cellulitis / complications
  • Orbital Cellulitis / diagnostic imaging
  • Papilledema / diagnosis
  • Veins / pathology*
  • Venous Thrombosis / diagnosis
  • Venous Thrombosis / etiology*
  • Venous Thrombosis / therapy

Substances

  • Anti-Bacterial Agents
  • Glucocorticoids