Kondo Ryushi, Kumabe Toshihiro, Yamamoto Daisuke, Koizumi Hiroyuki, Kuroda Hiroki, Miyasaka Kazuhiro
1 Department of Neurosurgery, Saitama Sekishinkai Hospital, Sayama, Japan.
2 Department of Neurosurgery, Kitasato University, Sagamihara, Japan.
Interv Neuroradiol. 2019 Aug;25(4):460-468. doi: 10.1177/1591019919829626. Epub 2019 Feb 25.
Although the abnormal venous drainage into the superior ophthalmic vein (SOV) is a well-known entity responsible for ocular symptoms, it remains unclear to what degree it affects the visual function. The purpose of this study was to evaluate the incidence, characteristics and outcomes of the visual disorders in patients with intracranial arteriovenous fistula (AVF) with venous drainage into the SOV.
This retrospective study involved eight patients diagnosed with intracranial AVFs with abnormal venous drainage into the SOV between January 2014 and December 2016.
The most common location of AVF was the cavernous sinus (CS) in five patients, followed by the intraorbit in two patients and superior sagittal sinus (SSS) in one patient. Visual disorders were detected in three patients (two intraorbit and one CS). The visual field contraction was observed in a patient with intraorbital AVF, and the reduction of visual acuity was confirmed in another patient with intraorbital AVF and a patient with CS dural AVF. All patients underwent an interventional treatment consisting of endovascular embolisation, stereotactic radiosurgery or both, which was selected based on their angioarchitecture. Although angiographic cure of AVF was confirmed in all patients, visual function did not fully recover in two patients with intraorbital AVF.
In cases of intraorbital AVF, visual disorders are more frequent and can result in poorer outcomes compared with other dural AVFs with drainage into the SOV. Early diagnosis and treatment are crucial to preserve the visual function of patients with intraorbital AVF.
尽管异常静脉引流至上眼静脉（SOV）是一种导致眼部症状的已知情况，但其对视觉功能的影响程度仍不清楚。本研究的目的是评估静脉引流至SOV的颅内动静脉瘘（AVF）患者视觉障碍的发生率、特征和结局。
这项回顾性研究纳入了2014年1月至2016年12月期间诊断为颅内AVF且静脉异常引流至SOV的8例患者。
AVF最常见的位置是5例患者的海绵窦（CS），其次是2例患者的眶内和1例患者的上矢状窦（SSS）。3例患者（2例眶内和1例CS）检测到视觉障碍。1例眶内AVF患者观察到视野收缩，另1例眶内AVF患者和1例CS硬脑膜AVF患者证实视力下降。所有患者均接受了基于血管结构选择的介入治疗，包括血管内栓塞、立体定向放射外科手术或两者结合。尽管所有患者的AVF在血管造影上均得到治愈，但2例眶内AVF患者的视觉功能未完全恢复。
与其他静脉引流至SOV的硬脑膜AVF相比，眶内AVF患者的视觉障碍更频繁，且可能导致更差的结局。早期诊断和治疗对于保留眶内AVF患者的视觉功能至关重要。
