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Gietzelt C, Wiedemann J, Lappas A, Koch K, Fricke J, Neugebauer A, Nähle CP, Hedergott A. [Thrombosis of the superior ophthalmic vein-A case series and review of the literature]. DIE OPHTHALMOLOGIE 2024:10.1007/s00347-024-02106-5. [PMID: 39266751 DOI: 10.1007/s00347-024-02106-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 07/18/2024] [Accepted: 08/05/2024] [Indexed: 09/14/2024]
Abstract
BACKGROUND Thrombosis of the superior ophthalmic vein (SOV) is rare. It can present with heterogeneous symptoms and requires a careful diagnostic work-up. METHODS This article reports on a case series of three female patients with thrombosis of the SOV and performed an extensive review of the existing literature in PubMed. RESULTS All three patients showed different leading symptoms but all had a triad of restricted eye motility, exophthalmos and a difference in intraocular pressure with the higher pressure on the side of the protruded eyeball. The pathophysiological background differed in all cases: in the two first cases a pre-existing anticoagulation treatment had been paused shortly before the event. Cofactors were an intraorbital venous outflow obstruction due to an unclear mass in the orbital apex in one case and hypercoagulability due to a malignant disease in the other case. In the third case, there was a cavernous sinus fistula. CONCLUSION The diagnosis should be considered not only in patients with dilated vessels of the anterior segment but also in unclear cases of exophthalmos or unilateral elevated intraocular pressure (IOP).
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Affiliation(s)
- Caroline Gietzelt
- Zentrum für Augenheilkunde, Universität zu Köln, 50924, Köln, Deutschland.
| | - Johanna Wiedemann
- Zentrum für Augenheilkunde, Universität zu Köln, 50924, Köln, Deutschland
| | - Alexandra Lappas
- Zentrum für Augenheilkunde, Universität zu Köln, 50924, Köln, Deutschland
| | - Konrad Koch
- Zentrum für Augenheilkunde, Universität zu Köln, 50924, Köln, Deutschland
- MVZ Augenärztliches Diagnostik- und Therapiecentrum (ADTC) Mönchengladbach/Erkelenz GmbH, Erkelenz, Deutschland
| | - Julia Fricke
- Zentrum für Augenheilkunde, Universität zu Köln, 50924, Köln, Deutschland
| | - Antje Neugebauer
- Zentrum für Augenheilkunde, Universität zu Köln, 50924, Köln, Deutschland
| | - Claas Philip Nähle
- Institut für Diagnostische und Interventionelle Radiologie, Universität zu Köln, Köln, Deutschland
- Radiologische Allianz, Hamburg, Deutschland
| | - Andrea Hedergott
- Zentrum für Augenheilkunde, Universität zu Köln, 50924, Köln, Deutschland
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Boutaj T, Lazaar H, Benkirane R, Sbai L, Tabchi M, Hilali Z, El Hachimi R, Tachfouti S, Amazouzi A, Cherkaoui O. Superior ophthalmic vein thrombosis in unique double origin: a case report. Pan Afr Med J 2024; 47:119. [PMID: 38828422 PMCID: PMC11143067 DOI: 10.11604/pamj.2024.47.119.42983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 02/19/2024] [Indexed: 06/05/2024] Open
Abstract
Superior ophthalmic vein thrombosis (SOVT) is a rare orbital pathology. It can cause serious complications if it isn´t diagnosed appropriately. It can be secondary to many etiologies, septic or aseptic ones. Diabetic ketoacidosis (DKA) may disturb the vascular endothelium and promote a prothrombotic state. The presence of which is related to a significantly increased risk of morbidity and mortality. We report the case of a 45-year-old woman who presented a SOVT revealing DKA. Orbit magnetic resonance imaging (MRI) showed thrombosis of the right superior ophthalmic vein. A treatment based on thrombolytic treatment, associated with antibiotic coverage and a glycemic balance was initiated. This case highlights the importance of considering both infection and diabetes as an important part of the diagnosis and management of SOVT.
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Affiliation(s)
- Taha Boutaj
- Ophthalmology Department “A”, Ibn Sina University Hospital (Hôpital des Spécialités), Mohammed V University, Rabat, Morocco
| | - Hamza Lazaar
- Ophthalmology Department “A”, Ibn Sina University Hospital (Hôpital des Spécialités), Mohammed V University, Rabat, Morocco
| | - Romaissae Benkirane
- Ophthalmology Department “A”, Ibn Sina University Hospital (Hôpital des Spécialités), Mohammed V University, Rabat, Morocco
| | - Latifa Sbai
- Ophthalmology Department “A”, Ibn Sina University Hospital (Hôpital des Spécialités), Mohammed V University, Rabat, Morocco
| | - Manal Tabchi
- Ophthalmology Department “A”, Ibn Sina University Hospital (Hôpital des Spécialités), Mohammed V University, Rabat, Morocco
| | - Zineb Hilali
- Ophthalmology Department “A”, Ibn Sina University Hospital (Hôpital des Spécialités), Mohammed V University, Rabat, Morocco
| | - Rim El Hachimi
- Ophthalmology Department “A”, Ibn Sina University Hospital (Hôpital des Spécialités), Mohammed V University, Rabat, Morocco
| | - Samira Tachfouti
- Ophthalmology Department “A”, Ibn Sina University Hospital (Hôpital des Spécialités), Mohammed V University, Rabat, Morocco
| | - Abdellah Amazouzi
- Ophthalmology Department “A”, Ibn Sina University Hospital (Hôpital des Spécialités), Mohammed V University, Rabat, Morocco
| | - Ouafa Cherkaoui
- Ophthalmology Department “A”, Ibn Sina University Hospital (Hôpital des Spécialités), Mohammed V University, Rabat, Morocco
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Menke BA, Ryu C, Chundury RV. Superior Ophthalmic Vein Thrombosis Associated With Asymptomatic COVID-19 Infection. Ophthalmic Plast Reconstr Surg 2024; 40:e41-e42. [PMID: 38427840 DOI: 10.1097/iop.0000000000002540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Abstract
Superior ophthalmic vein thrombosis is a rare condition scarcely described in clinical literature with potentially severe consequences including permanent vision loss. This report details the case of a 70-year-old woman who presented with acute binocular horizontal diplopia, relative proptosis of the OD by 4 mm, and pain OD. On exam, visual acuity was 20/20 OD and 20/30 OS with full extraocular movements. CT revealed proptosis OD with a thrombosed superior ophthalmic varix. Evaluation for etiology of hypercoagulability was unremarkable, although the patient did have an asymptomatic COVID-19 infection 1 month prior. To the authors' knowledge, this is the first reported case of superior ophthalmic vein thrombosis secondary to an asymptomatic COVID-19 infection.
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Affiliation(s)
- Bryant A Menke
- Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, Nebraska, U.S.A
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Colantonio MA, Arvon JN, Koenig N, Hendricks E, Abdullah A. SARS-CoV-2 associated septic venous cavernous sinus thrombosis: A case report. Radiol Case Rep 2024; 19:1090-1092. [PMID: 38229599 PMCID: PMC10789928 DOI: 10.1016/j.radcr.2023.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 12/08/2023] [Accepted: 12/12/2023] [Indexed: 01/18/2024] Open
Abstract
Cavernous sinus thrombosis (CST) is a life-threatening condition occurring due to an active infection, coagulation abnormalities, and trauma. Thromboembolic events are known complications secondary to novel coronavirus disease-19 (COVID-19) due to dysfunction in endothelial function and clotting factor dysfunction. We report a case of cavernous sinus thrombosis and delayed ophthalmic vein thrombosis associated with a preceding COVID-19 infection confirmed with a facial computed tomography (CT) scan. Clinicians should have a broad differential in patients with hypercoagulable states, as complications secondary to COVID-19 can be life-threatening.
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Affiliation(s)
- Mark A. Colantonio
- Department of Medicine, Division of Pulmonary, Critical Care & Sleep Medicine, West Virginia University School of Medicine, Morgantown, WV 26506 USA
| | - Jessica N. Arvon
- Department of Medicine, Division of Pulmonary, Critical Care & Sleep Medicine, West Virginia University School of Medicine, Morgantown, WV 26506 USA
| | - Nicholas Koenig
- Department of Medicine, Division of Pulmonary, Critical Care & Sleep Medicine, West Virginia University School of Medicine, Morgantown, WV 26506 USA
| | - Emily Hendricks
- Department of Medicine, Division of Pulmonary, Critical Care & Sleep Medicine, West Virginia University School of Medicine, Morgantown, WV 26506 USA
| | - Amirahwaty Abdullah
- Department of Medicine, Division of Pulmonary, Critical Care & Sleep Medicine, West Virginia University School of Medicine, Morgantown, WV 26506 USA
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Choudry H, Ata F, Ibrahim W, Rana MOR, Ahmad S, Mehmood A, Gill BA, Suheb MK. Saddle pulmonary embolism in the setting of COVID-19 infection: A systematic review of case reports and case series. Open Med (Wars) 2023; 18:20230724. [PMID: 37273918 PMCID: PMC10238810 DOI: 10.1515/med-2023-0724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 05/02/2023] [Accepted: 05/02/2023] [Indexed: 06/06/2023] Open
Abstract
Saddle pulmonary embolism (SPE) is a rare type of pulmonary embolism that can lead to hemodynamic compromise causing sudden deaths. Due to a dearth of large prospective studies in this area, little is known regarding the epidemiology, and prognosis and factors affecting the latter for COVID-19-associated SPE. We aimed to describe COVID-19-associated SPE and quantify and compare mortality and factors affecting mortality among the cases. We included a total of 25 publications with a total of 35 cases. The average age was 45 ± 16.3 years with 11 females and 24 males. Dyspnoea (82.5%), orthopnoea (43.5%), and cough (43.5%) were the most common symptoms, and obstructive shock was present in five (21.7%) patients. The average reported oxygen (O2) saturation was 85.8% ± 11.9 mm Hg. Hypertension (26.1%), diabetes (21.7%), and deep vein thrombosis (21.7%) were the most commonly reported comorbidities. Right heart strain was recognized in seven (30%) patients on electroencephalogram (S1QIIITIII) and 12 (52.2%) patients on echocardiogram. Anticoagulation, thrombolysis, and percutaneous intervention were tried in 21 (91.3%), 13 (56.5%), and 6 (26.1%) cases, respectively. Despite the aggressive management, 2 of 25 (8.7%) patients died in our smaller case report cohort. We conclude that despite aggressive management modalities, the mortality of SPE remains high in COVID-19.
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Affiliation(s)
- Hassan Choudry
- Department of Respiratory Medicine, University Hospital of Leicester, LeicesterLE1, UK
| | - Fateen Ata
- Department of Endocrinology, Hamad General Hospital, Hammad Medical Corporation, PO BOX 3050, Doha, Qatar
| | - Wanis Ibrahim
- Department of Internal Medicine and Pulmonology, Hammad Medical Corporation, Doha, Qatar
| | - Mohammad Omer Rehman Rana
- Department of Adult Cardiology, Chaudhary Pervaiz Ilahi Institute of Cardiology, Wazirabad, Pakistan
| | - Shoaib Ahmad
- Department of Medicine, Punjab Medical College, Faisalabad, Pakistan
| | - Asim Mehmood
- Respiratory Department, Derriford Hospital, University Hospitals Plymouth, Plymouth, UK
| | - Basir Afzaal Gill
- Intensive Care Unit, Department of Anaesthesia, Jinnah Hospital, Lahore, Pakistan
| | - Mahammed Khan Suheb
- Critical Care Department, St. Luke’s Aurora Hospital, Milwaukee, Wisconsin, USA
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Pace JL, Richard D, Khachik A, Mistry M, Singh G, Mostaghni N, Yazdanmehr S. Ophthalmic Presentations and Manifestations of COVID-19: A Systematic Review of Global Observations. Cureus 2023; 15:e40695. [PMID: 37485114 PMCID: PMC10359021 DOI: 10.7759/cureus.40695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2023] [Indexed: 07/25/2023] Open
Abstract
As the presentations and complications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continue to surface, the ocular manifestations have emerged as an area of interest. Research and reports conveyed the presence of several ophthalmic conditions observed in Coronavirus disease 2019 (COVID-19) patients. These publications documented a range of presentations varying from asymptomatic to serious impairments. The aim of this study is to characterize the ophthalmic pathologies and their frequencies observed due to COVID-19 in patients across different regions of the world. The goal is that the paper assists primary care physicians and healthcare providers. A systematic review of 31 articles published between January 1, 2021 to January 13, 2022, explored the presenting ocular symptoms of COVID-19, diagnosis, duration of ophthalmic complications, as well as pre-existing comorbidities. A total of 816 patients, 427 (52.3%) males and 389 (47.7%) females, from various regions of the world were investigated. Studies focusing on patients with a history of ocular pathologies, non-COVID-19 infections, complications associated with the COVID-19 vaccine, and pediatric patients were excluded from this study. Ocular complications were most commonly reported one to two weeks following the initial COVID-19 diagnosis. Analysis suggests that the "red" eye is the most prevalent presenting ophthalmologic symptom, followed by temporary vision loss. Conjunctivitis was also the most common clinical diagnosis reported, followed by neuro-retinal affection in the form of cotton wool spots (n=127 and n=9, respectively). This study summarizes ocular manifestations in COVID-19 patients and serves to help healthcare providers recognize common symptoms and their severity. This may lead to early diagnosis, treatment, and intervention of these manifestations.
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Affiliation(s)
- Jordan L Pace
- Medicine, California University of Science and Medicine, Colton, USA
| | - Drew Richard
- Medicine, California University of Science and Medicine, Colton, USA
| | - Adon Khachik
- Medicine, California University of Science and Medicine, Colton, USA
| | - Mehul Mistry
- Medicine, California University of Science and Medicine, Colton, USA
| | - Gagandeep Singh
- Medicine, California University of Science and Medicine, Colton, USA
| | - Navid Mostaghni
- Medicine, California University of Science and Medicine, Colton, USA
| | - Susan Yazdanmehr
- Medical Education, California University of Science and Medicine, Colton, USA
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Romano N, Urru A, Sasso R, Castaldi A. Imaging of superior ophthalmic vein: A pictorial overview. Clin Imaging 2022; 89:136-146. [DOI: 10.1016/j.clinimag.2022.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/20/2022] [Accepted: 06/28/2022] [Indexed: 11/03/2022]
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