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Superior ophthalmic vein thrombosis

Last revised by Mostafa Elfeky on 9 Nov 2023

Superior ophthalmic vein thrombosis is rare but can potentially lead to visual loss in the affected eye(s).

Superior ophthalmic vein thrombosis is very rare, with an incidence of 3-4 cases/million/year 1. It can be either unilateral or bilateral.

Superior ophthalmic vein thrombosis may manifest as 1,2:

  • painful proptosis

  • conjunctival congestion

  • chemosis

  • ophthalmoplegia

  • visual disturbance which can progress to loss of vision

Complications are usually due to the underlying pathology 1.

Etiologies can be divided into septic and aseptic 1,2:

The modalities of choice for the diagnosis of superior ophthalmic vein thrombosis are CT venography (CTV) and MR venography (MRV). The thrombus is visualized as a linear filling defect that dilates the vein and can extend into the ipsilateral cavernous sinus (if its origin was not the cavernous sinus, to begin with).

Immediate anticoagulant treatment should be instituted, as well as treatment for the underlying cause where applicable.

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Cases and figures

  • Case 1
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  • Case 2
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  • Case 3: with orbital cellulitis
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  • Case 4
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  • Case 5: bilateral
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