Pathological veins in the orbit

Orbital Cavernous Hemangioma: Role of Imaging

CT and MR imaging are particularly important in the diagnostic investigation of patients with vascular disorders of the orbit. The improved image quality of CT and MR imaging, along with dynamic CT angiography, MR angiography, MR venography, and multiphase dynamic contrast CT/MR imaging, has proven useful to delineate as well as differentiate various orbital vascular lesions. This article presents the current classification of orbital vascular disorders and describes the CT/MR imaging characteristics of orbital cavernous hemangiomas and simulating lesions.

Orbital varix with a pearly phlebolith. Case report

A patient is described with an orbital varix arising from the right superior ophthalmic vein, associated with ophthalmoplegia and severe pain, and without proptosis. The varix was detected using computerized tomography and orbital phlebography, and at surgery was verified as a venous aneurysm. During the operation, a pearly phlebolith was found. Histological examination of the varix revealed multiple ectatic venous channels. The etiology of this unusual clinical manifestation and the treatment of the patient are briefly discussed.

Orbital varix thrombosis

Venous disease of the orbit is a rare occurrence which can become manifest in a variety of ways including an arteriovenous aneurysm or fistula, a cavernous sinus or superior ophthalmic vein thrombosis, and an orbital varix, with and without thrombosis. Three patients had proptosis due to orbital varix thrombosis. The onset, degree of pain, and presence of diplopia were all variable. In two of three patients, computed tomographic (CT) scans showed lesions reminiscent of cavernous hemangiomas. The clinical, radiographic, surgical, and histopathologic features of this entity are described and discussed and a hypothesis is proposed to explain the pathophysiology of orbital varix thrombosis.

Intermittent exophthalmos studied with computerized tomography. Report of two cases

Two cases of intermittent exophthalmos are reported. In both instances, cerebral angiography and orbital venography failed to outline the lesion, which was clearly demonstrated with the aid of computerized tomography. An orbital varix was seen to be the cause of proptosis in one surgically verified case, whereas in the other this same diagnosis was suspected on the basis of the clinicoradiological findings. The etiology, clinical manifestations, and management of orbital varix are briefly discussed.

Sudden visual loss secondary to an orbital varix

A 45-year-old man presented with precipitous loss of vision and rapidly changing field defects in one eye. Computerized tomography and B-scan ultrasonography revealed a small orbital mass adjacent to the optic nerve. This was removed via lateral orbitotomy. On pathologic examination it was diagnosed as a small orbital varix. Drs. Frederick C. Blodi and Stephen Trokel comment on the case.