Some authors have found an aberrant ophthalmic vein
, whereas others have not observed structures passing through it [6, 9].
aa auditory artery, aov anterior orbital vein, ba basilar artery, cava communicating artery with vertebral artery, hy hypophysis, in internal naris (choana), nv nasal vein, onv orbitonasal vein, ov ophthalmic vein
, va vertebral artery.
Superior ophthalmic vein
thrombosis is a rare diagnosis that is generally associated with infectious conditions and hypercoagulable states related to cancer and/or autoimmune conditions.
Some researchers reported the decrease in the superior ophthalmic vein
blood flow velocity, and this may increase the severity of GO and optic neuropathy [9, 10].
Duman, "Colour Doppler imaging of superior ophthalmic vein
in thyroid-associated eye disease," Japanese Journal of Ophthalmology, vol.
An orbital MRI performed later demonstrated the presence of a dilated left superior ophthalmic vein
(Figure 2) and suggested a carotid cavernous fistula (CCF) as the provisional diagnosis.
If trans-arterial route is difficult, transvenous approach (Femoral route through the inferior petrosal sinus) or surgically through superior ophthalmic vein
may be warranted.
The PVP communicates with the cavernous sinus, ophthalmic vein
, maxillary vein, and facial vein; no valve exists between these veins.
Orbital magnetic resonance (MR) imaging showed left proptosis and cranial venous MR angiography demonstrated multiple tortuous and enlarged vessels near the left carotid artery and the left cavernous sinus resembling carotid-cavernous fistula, and enlarged superior ophthalmic vein
. The patient underwent successful endovascular stem-graft implantation for the left iatrogenic carotid-cavernous fistula.
But control cranial MRI and MR angiography image showed dilated superior ophthalmic vein
and a lesion congruent with CCF near internal carotid artery (Figure-1).
CT angiography revealed enlarged cavernous sinus with several dilated venous channels including ipsilateral superior ophthalmic vein
(SOV) in the right orbit.
In addition to these characteristic features, other findings may include: spinal meningeal diverticula, collapsed superior ophthalmic vein
, reduction in the angle of vein of Galen and internal cerebral vein (the venous hinge sign).19-24