Orbital Varix Research Articles

Orbital Varix and Its Surgical Correction - A Case Report

AbstractA Young patient presented with left unilateral proptosis and Orbital venography was suggestive of orbital vari on left side. An easy and effective operative procedure was planned. The superficial veins around orbit were ligated. Result was acceptable and without complications. This proved an effective and simple approach as against trans-cranial or orbital approach for surgical removal of vari.

Computed perimetry study of optic nerve compression caused by orbital tumors

Seventeen cases of compressive optic neuropathy caused by orbital masses were examined with a 30-degree threshold program of automated perimetry. The orbital pathologies were represented by five cases of Graves' orbitopathy, three optic nerve sheath meningiomas, two hemangiopericytomas, two diffuse pseudotumors, one perineuritis, one case of orbital varices with hemorrhage, one lymphoma, one ethmoidal carcinoma and one suspected angioma. Visual field alterations varied from arcuate, inferior altitudinal and cecocentral scotomas, to temporal hemianopsy, nasal step and diffuse losses. In three cases (one Graves', one acute diffuse pseu-dotumor and one perineuritis), steroid administration was followed by partial or full perimetric recovery; in one case (orbital varices with hemorrhage) the full recovery was spontaneous, while in one case of benign hemangiopericytoma, the surgical removal of the tumor caused a significant improvement of the visual field.In the authors' series, perimetric pattern reflects the...

Varicosis orbitalis

Three patients with intermittent exophthalmos were studied by computed tomography (CT) and colour-coded Doppler sonography (CCDS). By CT the possible diagnosis of an orbital varix was established. CCDS, however, with the dynamic evaluation and realtime direct imaging of flow and the possibility of examination in different positions facilitated the diagnosis of this orbital vascular disorder without the need for any contrast material. This technique may prove to be a useful adjunct to computed tomography for the evaluation of suspected vascular lesions of the orbit. Surgery confirmed the diagnosis in all patients.

Orbital Varix

A case of orbital varix is presented in which the lesion is well demonstrated by color flow Doppler sonography. Correlation is made with CT and MR studies. We believe that color flow sonography should be used as the initial screening test in cases of suspected orbital varix.

Orbital varix with a pearly phlebolith

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.

Colour Doppler imaging in the demonstration of an orbital varix.

Colour Doppler imaging (CDI) is a recent development in ultrasonography. It allows simultaneous two-dimensional structural imaging and Doppler evaluation of blood flow. Quantitative information on flow velocity is obtained by pulsed Doppler spectral analysis, the colour information being used to choose the vessel of interest. Using this technique the authors examined a patient with an orbital varix previously diagnosed by clinical findings and computed tomography. Dynamic evaluation with real-time direct imaging of flow facilitated the diagnosis of this orbital disorder without the need for any contrast material. This technique may prove to be a useful adjunct to computed tomography for the evaluation of suspected vascular lesions of the orbit.

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.

Orbital Hemorrhage and Eyelid Ecchymosis in Acute Orbital Myositis

We examined two patients with acute orbital myositis associated with orbital hemorrhage and eyelid ecchymosis. Both patients were young women (aged 22 and 30 years) who had painful proptosis, diplopia, and computed tomographic evidence of single extraocular muscle involvement with spillover of inflammatory edema into the adjacent orbital fat. Patient 1 showed contralateral preseptal eyelid inflammation and did not suffer an orbital hemorrhage until after an episode of vomiting. In Patient 2, the diagnosis of occult orbital varix was initially considered but an orbital exploration and a biopsy specimen showed no vascular anomaly. Both patients were treated successfully with high-dose systemic corticosteroids. Some cases of idiopathic orbital inflammation may be related to preexisting vascular anomalies or orbital phlebitis.

Ein ungewöhnlicher Fall: episklerale und orbitale Varizen

A rare case of episcleral and orbital varix in a 16-year-old female is reported. The diagnosis was confirmed by CT scan and ultrasonography, and showed during Valsalva's maneuver a typical expansion of the orbital tumor. CT scan showed the tumor to be composed of a plexus of dilated vessels. During Valsalva's maneuver a 10 mm Hg rise in the venous pressure in the episcleral varix was noted, which suggests a direct communication between the episcleral and the orbital varices.

Dynamic Proptosis

Dynamic proptosis can be defined as exophthalmos occurring when a variable force is applied to the orbital contents. In a series of 26 patients (13 males and 13 females, 1 to 82 years old), the causes of dynamic proptosis included neurofibromatosis (nine cases), fistulas (three cases), malignancies (three cases), meningoencephaloceles (two cases), mucoceles (two cases), surgery (two cases), orbital varix (two cases), dermoid cysts (two cases), and aneurysm (one case). Dynamic proptosis can be either spontaneous or induced, and can occur either with an intact or an incompetent bony orbit.

Magnetic resonance imaging of an orbital varix with CT and ultrasound correlation

A case of orbital varix demonstrated with computed tomography, ultrasound, and magnetic resonance imaging is reported. The clinical and radiographic findings are discussed.

Complication of venography in varicocele

The authors outline the danger of direct venography in orbital varices because of the inherent tendency of these thin-walled dilated veins to bleed easily and result in orbital hemorrhage. One instance of such a complication is reported. Computed tomography with the Valsalva maneuver is a safe diagnostic substitute.

Bilateral orbital varices:Report of a patient presenting with thrombosis of an inferior nasal varix

Orbital varices are rare venous anomalies that usually produce a unique clinical picture of intermittent proptosis associated with dependency of the head, jugular vein compression, the Valsalva maneuver, and other mechanisms elevating ocular venous pressure. We report the case of a 71-year-old male who presented with the acute onset of a cystic mass below the right inner canthus and associated vertical diplopia. Subsequent radiologic and histopathologic evaluation revealed a thrombosed, prolapsed varix with underlying bilateral orbital varices. The patient had sustained facial trauma two years previously and a post-traumatic etiology is postulated. The patient's clinical, physical and radiologic findings are discussed, and the characteristic features of orbital varices are reviewed.

Enophthalmos: A Clinical Review

Twenty-six cases of enophthalmos were reviewed. The causes in order of frequency were: orbital asymmetry (8); trauma (5); orbital metastasis (4); microphthalmos (2); orbital varix (2); maxillary mucocoele (2); localized scleroderma (1); absence of sphenoid wing (neurofibromatosis) (1); post irradiation atrophy (1). Only six of the patients (23%) were referred with the diagnosis of enophthalmos, suggesting the sign may be subtle and is frequently missed or misdiagnosed. The nature of the causes underscore the need for careful and thorough diagnosis. In particular, the therapeutic implications of diagnosing metastatic disease, maxillary mucocoele, and orbital varices is noted. A review of etiology and mechanisms of enophthalmos point to the diversity, importance and conditions causing this sign.

Orbital tumors in children

In five years ending in 1982 we examined 74 cases of orbital disease in children below the age of 15. This represents an incidence of about 20% of all orbital tumors seen in the Eye Department of the Hellenic Anticancer Institute, in the same period of time. Vascular tumors, malignant neoplasms and inflammations were the commonest causes. Among the vascular tumors, capillary hemangiomas and orbital varices were almost exclusively seen.There were several children with the signs and symptoms of varices, in whom orbital venography was negative for varices. We named these cases hematic cysts of the orbit. An attempt was made to explain this entity on the basis of our findings.

Orbital varices as a cause of headache; phlebographic aspects

(1983). Orbital varices as a cause of headache; phlebographic aspects. Orbit: Vol. 2, No. 1, pp. 51-53.

Sector B-scan ultrasonographic 'hemangiomalike' pattern.

Eleven patients with unilateral exophthalmos had sector B-scan ultrasonography. The ultrasonograms were all similar and demonstrated a "hemangiomalike" pattern consisting in a rounded, well-outlined orbital mass with a sharp anterior border, moderate to strong tissue reflectivity, and fair to good sound transmission. Although the postoperative pathologic findings in six cases confirmed the presence of cavernous hemangioma of the orbit, other lesions, such as hemangiopericytoma, lymphangioma, orbital varix, meningioma, and mixed cell tumor, were found to show a similar ultrasonographic pattern.

Echographic appearance of orbital veins Jacques Poujol and Michel Le Roy

Orbital veins can easily be demonstrated by ultrasound when they are dilated. They appear as a non-echogenic defect in the orbital fat, linear or round, the shape depending on the orientation of the ultrasound plane. Thickening of the choroid is frequently associated with it. Such echographic pictures are to be distinguished from those of orbital varices and of rectus muscles. They are completely different from the pictures given by orbital hemangiomas.

Surgical treatment of orbital varices

Surgical treatment of orbital varices

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.