Superior ophthalmic vein
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At the time the article was created Craig Hacking had no recorded disclosures.View Craig Hacking's current disclosures
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The superior ophthalmic vein is a prominent vein of the orbit that is seen on CT and may be enlarged or tortuous in various disease entities.
Formed in the anterior part of the orbit by the union of the angular, supraorbital and supratrochlear veins.
- courses laterally within the intraconal space (with the ophthalmic artery) to travel between the superior rectus muscle above and the optic nerve and ophthalmic artery below 1
- exits the intraconal space to become extraconal
- exits the orbit via the superior orbital fissure superior to the annulus of Zinn between the frontal (branch of V1) and trochlear nerves
- drains directly into the cavernous sinus
- vortex veins draining choroid
- central retinal vein
- veins that correspond to branches of the ophthalmic artery (ethmoidal vein, lacrimal)
The mean diameter of the vein is 2 mm and normal sizes range from 1 to 2.9 mm 2. A threshold value of 2.5 mm has also been proposed 3.
Enlarged or tortuous superior ophthalmic veins may be seen in:
- carotid-cavernous fistula
- ophthalmic vein varix
- raised intracranial pressure
- Graves disease
- orbital pseudotumor
- superior ophthalmic vein thrombosis
Reversible bilateral enlargement of the superior ophthalmic veins is often seen in intubated patients 3. The superior ophthalmic veins may be hyperdense on CT due to thrombosis, including in cases of orbital cellulitis.
- 1. Cheung N & McNab A. Venous Anatomy of the Orbit. Invest Ophthalmol Vis Sci. 2003;44(3):988-95. doi:10.1167/iovs.02-0865 - Pubmed
- 2. Ozgen A & Aydingöz U. Normative Measurements of Orbital Structures Using MRI. J Comput Assist Tomogr. 2000;24(3):493-6. doi:10.1097/00004728-200005000-00025 - Pubmed
- 3. Nabavizadeh S, Sundararajan S, Schmitt J, Loevner L. Reversible Dilation of the Superior Ophthalmic Vein in Intubated Patients. AJNR Am J Neuroradiol. 2018;39(8):1505-8. doi:10.3174/ajnr.A5699 - Pubmed
- 4. Raymond Jack Last, Robert Matthew Hay McMinn. Last's anatomy, regional and applied. (1994) ISBN: 9780443046629