Massive Thrombosis of Bilateral Superior and Inferior Ophthalmic Veins Secondary to Ethmoidal Rhinosunisitis

Abstract

Ophthalmic vein thrombosis (OVT) is a rare condition occurring secondary to varied etiologies that commonly presents with proptosis, globe dystopia, ophthalmoplegia, periorbital edema, and occasionally diminished visual acuity. It may be related to inflammation of the orbit or paranasal sinuses. We herein report imaging findings of thrombosed superior and inferior ophthalmic veins in bilateral involvement in a 20-year-old male patient without cavernous sinus thrombosis. He presented with pain, swelling, and blurred vision in both eyes. Magnetic resonance (MR) imaging, cerebral MR angiography, and susceptibility weighted imaging were performed. Bilateral superior and inferior OVT due to a complication of ethmoidal sinusitis was diagnosed in the patient. Anticoagulant and systemic broad-spectrum antibiotic therapy was started. His symptoms were recorded at the end of 14 days of the treatment.

Impact of superior ophthalmic vein thrombosis: a case series and literature review

“…In literature, paranasal sinusitis is the most common cause of septic SOVT. 13,[27][28][29][30][31][32][33] In our series, the majority of cases were aseptic (77.8%). This corresponds to the literature, where we also found more aseptic SOVT (66.7%).…”

Concurrent Atlantoaxial Septic Arthritis and Septic Thrombosis of the Ophthalmic Vein due to Staphylococcus aureus: A Case Report and Review of the Literature

“…Although anticoagulation may reduce morbidity and mortality for people with cavernous sinus thrombosis, its role for treating superior ophthalmic vein thrombosis is less clear. In our review, 7 cases received anticoagulation, with 1 fatal outcome attributed to a retroperitoneal bleed [15] while 6 other case reports described anticoagulation including with heparin, low–molecular weight heparin, and aspirin without sequelae [11, 12, 14, 16, 17, 20]. The decision to start anticoagulation for individuals with septic superior ophthalmic vein thrombosis is still best considered on a case-by-case basis, taking into account age, comorbid conditions, response to antibiotic therapy, and whether invasive procedures were performed.…”

Superior Ophthalmic Vein Thrombosis Induced by Orbital Cellulitis: An Ophthalmic Emergency

“…The presentation of SOVT varies depending on the underlying pathology, with the most common etiologies being infection, trauma, neoplasm, and vasculitis [1]. The most commonly reported cases of SOVT are associated with infectious etiology of surrounding structures, such as orbital cellulitis (OC) [2][3][4][5][6][7][8], sinusitis [9,10], dental abscess [7,11], and cutaneous infection [12][13][14]. Due to the strong association with orbital cellulitis, suspicion of SOVT is high if the physical examination is suggestive of optic nerve or orbital involvement [1].…”