Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jul 11:6:258-264.
doi: 10.1016/j.ejro.2019.07.002. eCollection 2019.

Superior ophthalmic vein thrombosis: What radiologist and clinician must know?

Houman Sotoudeh  1 , Omid Shafaat  2 , Noha Aboueldahab  3 , Michael Vaphiades  4 , Ehsan Sotoudeh  5 , Joshua Bernstock  6
Affiliations

Superior ophthalmic vein thrombosis: What radiologist and clinician must know?

Houman Sotoudeh et al. Eur J Radiol Open. .

Erratum in

Abstract

Purpose: Superior ophthalmic vein thrombosis (SOVT) is an extremely rare condition. Few studies have been published about clinical aspects of this condition. In this study, we have studied the symptoms, underlying etiologies, treatment, pathogenesis and complication of the SOVT and we tried to classify it based on the etiology, treatment, and prognosis.

Methods: We reviewed the patients' data from a tertiary academic referral center. Each patient with SOVT was then reviewed for symptoms associated with SOVT, underlying etiology, treatment protocol, treatment response, complications, possible pathogens, and final outcome.

Results: Twenty-four cases of SOVT were included in this study. Overall, 13 cases were diagnosed as right-sided SOVT, out of which, eight had simultaneous right-sided cavernous sinus thrombosis (CST). Eighteen cases were diagnosed to have left-sided SOVT, out of which, 11 had simultaneous left-sided CST.

Conclusions: The SOVT can be secondary to different mechanisms. The SOVT secondary to trauma, recent surgery and coagulopathy are mostly non-aggressive, and can be managed by conservative therapy and anticoagulation. The SOVT in patients with orbital cellulitis, history of active sinusitis or paranasal sinus surgery are aggressive presenting with acute orbital swelling, abscess and visual loss. This type of SOVT can be complicated by extension to the cavernous sinus and intracranial structures. These patients require urgent antibiotics therapy and sinus surgery. The most severe type of SOVT is caused by mucormycosis which may also extend intracranially resulting in stroke and is often life-threatening.

Keywords: B/L, bilateral; CCF, carotid cavernous fistula; CST, cavernous sinus thrombosis; CT, computed tomography; Cavernous sinus thrombosis; F, female; IRB, institutional review board; L, left; M, male; MRI, magnetic resonance Imaging; N/A, not applicable; Orbital cellulitis; R, right; RA, rheumatoid arthritis; SCC, Squamous Cell Carcinoma; SLE, systemic lupus erythematosus; SOV, superior ophthalmic vein; SOVT, superior ophthalmic vein thrombosis; Sinusitis; Superior ophthalmic vein thrombosis; Thrombophlebitis; UTI, Urinary Tract Infection; Y, yes.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Coronal post-contrast T1 weighted MRI demonstrates dilation of the left superior ophthalmic vein with internal filling defect. Diagnostic for the left SOVT (arrow).
Fig. 2
Fig. 2
Coronal post-contrast CT demonstrates dilation of the right superior ophthalmic vein with internal thrombosis consistent with right SOVT (arrow).
Fig. 3
Fig. 3
Coronal post-contrast coronal CT demonstrates expansion of the cavernous sinuses with internal filling defect diagnostic for bilateral cavernous sinus thrombosis (arrows).
Fig. 4
Fig. 4
Coronal post-contrast T1 sequence shows evidence of bilateral SOVT with expansion of veins and lack of enhancement (arrows).The patient is status post functional sinus surgery with persistent sinusitis.
Fig. 5
Fig. 5
Coronal post-contrast T1 show left SOVT (arrow A) with thrombosis of bilateral cavernous sinuses (arrow B).
Fig. 6
Fig. 6
Axial and coronal post-contrast T1 show left sided SOVT (arrows A and B) with extension to left cavernous sinus (arrow C). Evidence of left orbital cellulitis is also noted.
Fig. 7
Fig. 7
Coronal post-contrast CT shows bilateral SOVT with venous dilation and lack of enhancement (arrows).
Fig. 8
Fig. 8
Axial and coronal post-contrast CT show right SOVT with dilation and lack of enhancement (arrows A and B).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Park H.S., Gye H.J., Kim J.M., Lee Y.J. A patient with branch retinal vein occlusion accompanied by superior ophthalmic vein thrombosis due to severe superior ophthalmic vein enlargement in a patient with graves ophthalmopathy. J. Craniofac. Surg. 2014;25(4):e322–4. - PubMed
    1. Gupta R.K., Jamjoom A.A., Devkota U.P. Superior sagittal sinus thrombosis presenting as a continuous headache: a case report and review of the literature. Cases J. 2009;2:9361. - PMC - PubMed
    1. Michaelides M., Aclimandos W. Bilateral superior ophthalmic vein thrombosis in a young woman. Acta Ophthalmol. Scand. 2003;81(1):88–90. - PubMed
    1. Lim L.H., Scawn R.L., Whipple K.M., Oh S.R., Lucarelli M.J., Korn B.S., Kikkawa D.O. Spontaneous superior ophthalmic vein thrombosis: a rare entity with potentially devastating consequences. Eye (Lond.) 2014;28(3):348–351. - PMC - PubMed
    1. Mandic J.J., Mandic K., Mrazovac D. Superior ophthalmic vein thrombosis with complete loss of vision as a complication of autoimmune and infective conditions. Ocul. Immunol. Inflamm. 2018;26(7):1066–1068. - PubMed