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

Christopher R. Adam, Carol L. Shields, Justin Gutman, H. Joon Kim, Brent Hayek, John W. Shore, Alexandra Braunstein, Flora Levin, Bryan J. Winn, Ivan Vrcek, Ronald Mancini, Craig Linden, Christina Choe, Mithra Gonzalez, David Altschul, Santiago Ortega-Gutierrez, Srinivasan Paramasivam, Johanna T. Fifi, Alejandro Berenstein, Vikram DurairajRoman Shinder

Research output: Contribution to journalArticle

10 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)68-73
Number of pages6
JournalOphthalmic plastic and reconstructive surgery
Volume34
Issue number1
DOIs
StatePublished - Jan 1 2018

ASJC Scopus subject areas

  • Surgery
  • Ophthalmology

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    Adam, C. R., Shields, C. L., Gutman, J., Kim, H. J., Hayek, B., Shore, J. W., Braunstein, A., Levin, F., Winn, B. J., Vrcek, I., Mancini, R., Linden, C., Choe, C., Gonzalez, M., Altschul, D., Ortega-Gutierrez, S., Paramasivam, S., Fifi, J. T., Berenstein, A., ... Shinder, R. (2018). Dilated Superior Ophthalmic Vein: Clinical and Radiographic Features of 113 Cases. Ophthalmic plastic and reconstructive surgery, 34(1), 68-73. https://doi.org/10.1097/IOP.0000000000000872