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Case Reports
. 2014 Mar;28(3):348-51.
doi: 10.1038/eye.2013.273. Epub 2013 Dec 20.

Spontaneous superior ophthalmic vein thrombosis: a rare entity with potentially devastating consequences

L H Lim  1 , R L Scawn  2 , K M Whipple  2 , S R Oh  2 , M J Lucarelli  3 , B S Korn  2 , D O Kikkawa  2
Affiliations
Case Reports

Spontaneous superior ophthalmic vein thrombosis: a rare entity with potentially devastating consequences

L H Lim et al. Eye (Lond). 2014 Mar.

Abstract

Purpose: Spontaneous superior ophthalmic vein thrombosis (SOVT) is a rare entity. We describe three patients with spontaneous ophthalmic vein thrombosis, each with various risk factors.

Patients and methods: A retrospective review of three patients with a diagnosis of superior ophthalmic vein thrombosis. Clinical characteristics, radiographic features, management techniques and outcomes are described.

Results: All patients presented with unilateral painful proptosis. Two patients had intact light perception, whereas one patient presented with absent light perception. All patients had identifiable risk factors for thrombosis, which included sickle cell trait, hereditary hemorrhagic telangectasia and colon cancer with recurrent deep vein thrombosis. Anticoagulation was initiated in two patients. Resolution of proptosis was seen in all patients, with no recovery of vision in one patient.

Conclusions: Risk factors for spontaneous superior ophthalmic vein thrombosis are multifactorial. MRI and MRV confirm the diagnosis of SOVT. Despite urgent intervention devastating visual loss may occur.

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Figures

Figure 1
Figure 1
(a and b) Case 1. Axial and coronal MRI and MRV showing intraluminal thrombosis and dilation of the right SOV (arrows). (c) Case 1. Axial CT angiogram showing resolution of SOV thrombosis 4 months later (arrow).
Figure 2
Figure 2
(a and b) Case 2. Axial and coronal MRI and MRV showing bilaterally enlarged SOV, more pronouced on the right with intraluminal thrombus (arrow).
Figure 3
Figure 3
(a and b) Case 3. Axial and coronal CT revealing enlarged and thrombosed left SOV (arrow) and diffusely enlarged extraocular muscles.
See this image and copyright information in PMC

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