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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.
How to master MCQs
Published in Chung Nen Chua, Li Wern Voon, Siddhartha Goel, Ophthalmology Fact Fixer, 2017
Enlarged superior ophthalmic vein occurs when the drainage of venous blood into the cavernous sinus is impaired. This occurs in carotid cavernous fistula and cavernous sinus thrombosis. The other conditions mentioned do not increase the pressure of the cavernous sinus or impair venous drainage.
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
Ocular Adverse Events After COVID-19 Vaccination
Published in Ocular Immunology and Inflammation, 2021
Xin Le Ng, Bjorn Kaijun Betzler, Ilaria Testi, Su Ling Ho, Melissa Tien, Wei Kiong Ngo, Manfred Zierhut, Soon Phaik Chee, Vishali Gupta, Carlos E Pavesio, Marc D. de Smet, Rupesh Agrawal
Regarding post-vaccination thrombosis, rare cases of post vaccination immune thrombotic thrombocytopenia and cerebral venous sinus thrombosis (CVST) after administration of the adenovirus vector vaccines ChAdOx1 nCoV-19 and Ad26.COV2 have been well described.52–57 Anatomically, CVST post-COVID-19 vaccination has been reported to occur in virtually all the dural venous sinuses,52 and a majority of patients are females.52 This section focuses on superior ophthalmic vein thrombosis, as reported in two isolated cases.21,58 Both patients received the ChAdOx1 nCoV-19 vaccine. Panovska-Stavridis et al.58 describe a 29-year-old female who presented with severe headache, orbital swelling with proptosis, limited ocular motility, vertical diplopia, and reduced visual acuity 10 days after the first dose. Initial findings showed thrombocytopenia of 18 × 109/L and high D-dimer levels of 35712 μg/L. Antibody screening showed high levels of antibodies against Heparin/Platelet Factor 4 complex. Contrast-enhanced MRI demonstrated central filling defects and a widened and enhanced left SOV, revealing thrombosis. The patient was treated with intravenous immunoglobulin (IVIG) for two days followed with tapered oral prednisolone. All symptoms resolved within 5 days. Bayas et al.21 described a 55-year-old female with bilateral SOV thrombosis on post-dose day 10, also definitively diagnosed on MRI showing filling defects and T2 enhancement of both SOV. Laboratory investigations supported a diagnosis of secondary immune thrombocytopenia. Despite therapeutic heparinization, the patient developed an ischemic stroke in the left parietal lobe, middle cerebral artery region on post-dose day 18. Healthcare professionals should be on the alert for possible cases of thromboembolism – CVST, pulmonary, deep vein thrombosis, or in the ophthalmic context – SOV thrombosis – after ChAdOx1 nCoV-19 or Ad26.COV2 administration.
Bilateral superior ophthalmic vein thrombosis associated with high altitude
Published in Orbit, 2021
Abtin Shahlaee, Lauren M. Hennein, Bryan J. Winn, William P. Dillon, Nailyn Rasool
The superior ophthalmic vein is a valve-less vein responsible for most of the venous drainage of the orbit. Superior ophthalmic vein thrombosis is a serious condition which often presents with diplopia, proptosis, orbital fullness, and vision loss. If not identified and managed appropriately it can result in blindness and even death from potentiation of the thrombosis intracranially.