Gietzelt Caroline, Wiedemann Johanna, Lappas Alexandra, Koch Konrad, Fricke Julia, Neugebauer Antje, Nähle Claas Philip, Hedergott Andrea
Zentrum für Augenheilkunde, Universität zu Köln, 50924, Köln, Deutschland.
MVZ Augenärztliches Diagnostik- und Therapiecentrum (ADTC) Mönchengladbach/Erkelenz GmbH, Erkelenz, Deutschland.
Ophthalmologie. 2024 Nov;121(11):886-893. doi: 10.1007/s00347-024-02106-5. Epub 2024 Sep 12.
Thrombosis of the superior ophthalmic vein (SOV) is rare. It can present with heterogeneous symptoms and requires a careful diagnostic work-up.
This article reports on a case series of three female patients with thrombosis of the SOV and performed an extensive review of the existing literature in PubMed.
All three patients showed different leading symptoms but all had a triad of restricted eye motility, exophthalmos and a difference in intraocular pressure with the higher pressure on the side of the protruded eyeball. The pathophysiological background differed in all cases: in the two first cases a pre-existing anticoagulation treatment had been paused shortly before the event. Cofactors were an intraorbital venous outflow obstruction due to an unclear mass in the orbital apex in one case and hypercoagulability due to a malignant disease in the other case. In the third case, there was a cavernous sinus fistula.
The diagnosis should be considered not only in patients with dilated vessels of the anterior segment but also in unclear cases of exophthalmos or unilateral elevated intraocular pressure (IOP).
眼上静脉血栓形成较为罕见。其症状多样,需要进行细致的诊断检查。
本文报道了3例眼上静脉血栓形成的女性患者病例系列,并对PubMed中现有文献进行了全面回顾。
所有3例患者均表现出不同的主要症状,但都有眼球运动受限、眼球突出以及患侧眼压较高导致的眼压差异这一组三联征。所有病例的病理生理背景各不相同:前两例中,事件发生前不久停用了先前的抗凝治疗。其中1例的辅助因素是眶尖不明肿物导致眶内静脉流出道梗阻,另1例是恶性疾病导致的高凝状态。第3例存在海绵窦瘘。
不仅前段血管扩张的患者,而且眼球突出或单侧眼压升高原因不明的患者,均应考虑该诊断。