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Paper 2
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
What is the most likely finding?Orbital massDilated superior ophthalmic veinThrombosis of the cavernous sinusOptic nerve enlargementAneurysm of the ophthalmic artery
Head and Neck
Published in Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno, Understanding Human Anatomy and Pathology, 2018
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno
Most of the blood vessels of the orbital region (Plate 3.34) are branches of the ophthalmic artery, which enters the orbit through the optic canal, inferior to the optic nerve. It gives off the central artery of the retina, then divides into the lacrimal artery, the supratrochlear and supraorbital arteries (Plate 3.22). The major veins of the orbital region are the superior ophthalmic vein, which anastomoses with the angular vein, and the inferior ophthalmic vein (Plate 3.23; described in detail in Section 3.3.2).
Headache associated with nonvascuiar intracranial disorders
Published in Stephen D. Silberstein, Richard B. Upton, Peter J. Goadsby, Headache in Clinical Practice, 2018
Stephen D. Silberstein, Richard B. Upton, Peter J. Goadsby
Chen et al86 used color Doppler flow imaging to measure superior ophthalmic vein blood flow in patients with suspected intracranial hypotension (orthostatic headache and clinical features of intracranial hypotension). The mean diameter of the superior ophthalmic vein was substantially larger in the patients with intracranial hypotension (3.9 (SD 0.2) mm) than in the healthy controls (2.6 (SD 0.4) mm) and the headache controls (2.7 (SD 0.2) mm) (p <0.0001). The mean maximum flow velocity was significantly higher in the intracranial hypotension group (17.0 (SD 3.4) cm/s) than in the healthy controls (7.9 (SD 1.1) cm/s) and the other patients (7.3 (SD 1.7) cm/s) (p <0.0001). Seven patients with intracranial hypotension were reassessed after being treated with an epidural blood patch. The clinical symptoms were relieved and there was a striking reversal of the superior ophthalmic vein flow. Superior ophthalmic vein blood flow measured by color doppler flow imaging may provide a practical, simple, and non-invasive diagnostic method for suspected intracranial hypotension.
A Lesson Learnt from a Dural Carotid Cavernous Fistula-induced Superior Ophthalmic Vein Occlusion with Posterior Ischaemic Optic Neuropathy
Published in Neuro-Ophthalmology, 2022
Tung Thanh Hoang, Cuong Ngoc Nguyen, Thanh Thien Huy Ha, Prem S. Subramanian
A dural CCF occurs due to pathological communication between meningeal branches of ECA, ICA, or both with the cavernous sinus.1 In dural CCFs, disturbed flow may cause a remodelling process of the venous endothelium and venous arterialisation, leading to superior ophthalmic vein occlusion.2–4 In our case, we hypothesise that the capillary pressure increase could have been the consequence of long-lasting ophthalmic vein occlusion, which reduced flow in the ophthalmic artery branches. This is similar to the mechanism of ischaemic retina in central retinal vein occlusion and could explain the angiographic manifestation of the right ophthalmic artery branches.5 Steal phenomenon in which blood from ophthalmic artery is stolen through the dural CCF might be a mechanism explaining the reduction of blood supply to the posterior orbital segment of optic nerve.6,7 In this case, ophthalmic vein obstruction was overlooked on TOF MR angiography because of the low flow in the dural CCF.
The Effects of Acute Intracranial Pressure Changes on the Episcleral Venous Pressure, Retinal Vein Diameter and Intraocular Pressure in a Pig Model
Published in Current Eye Research, 2021
Deepta Ghate, Sachin Kedar, Shane Havens, Shan Fan, William Thorell, Carl Nelson, Linxia Gu, Junfei Tong, Vikas Gulati
The study protocol was approved by the Institution’s Animal Care and Use Committee (IACUC). All studies were conducted in accordance with the United States Public Health Service’s Policy on Humane Care and Use of Laboratory Animals. For this exploratory study, we used an established porcine model of acute ICP fluctuations, which was recently developed at our institution, to model non-invasive ophthalmic biomarkers of acute ICP changes.17 This model was chosen due to prior surgeon experience with lumbar and intracranial CSF access in the species (Sus domesticus) and comparable intra-cranial, intra-orbital and ocular anatomy with humans.18 In both species, the episcleral veins and retinal veins drain into the cavernous sinus through the superior ophthalmic vein (humans) or the ophthalmic plexus (pigs).
Impact of superior ophthalmic vein thrombosis: a case series and literature review
Published in Orbit, 2019
Nicolien A. van der Poel, Kornelis D. de Witt, René van den Berg, Maartje M. de Win, Maarten P. Mourits
The superior ophthalmic vein is a valve-less vein which is responsible for most of the venous drainage of the orbit. SOVT is caused by altered venous blood flow, which can be the result of stasis of blood flow, trauma to the vessel wall, or hypercoagubility disorders. Both septic and aseptic causes of SOVT are known. Aseptic causes of SOVT can be explained by alterations of blood flow due to anatomical or systemic causes. SOVT is seen in patients with flow alterations in the orbital vascular system, such as in dural arteriovenous fistulae in the direct vicinity of the cavernous sinus.1–5 Facial trauma is another aseptic cause of SOVT, reported in literature.6–8 Systemic diseases reporting SOVT in literature include Graves’ Orbitopathy, systemic lupus erythematosus, and ulcerative colitis.9–13 Hematologic aetiologies include antiphospholipid syndrome and sickle trait.14–17 Also, hormone therapies have been reported as a cause for SOVT (e.g. tamoxifen, oral contraceptive pill).18–20 Other causes of aseptic SOVT include Tolosa-Hunt syndrome and idiopathic orbital inflammatory disease.21,22 Not seldom, the cause remains unknown despite investigations for coagulation disorders or systemic diseases.23–26 On the other hand, in some cases SOVT can be the first clinical sign of a new diagnosis such as arteriovenous fistulae or systemic disorders.11,12