Clinical case of 9-month observation of orbital venous varicose with intraluminal thrombus using radiologic methods

A rare clinical case of thrombosis of varicose superior ophthalmic vein in combination with a unilateral venous anomaly of the subcortical region of the brain with successful antithrombotic therapy is presented. Varicose veins of the superior ophthalmic vein are rare (2% of all orbital formations) and are a risk factor for thrombosis.

Material and methods. A 41-year-old patient with verified thrombosis of unilateral orbital venous varicose veins was observed for 9 months. Initially, MSCT of the brain and MSCT angiography were performed, then dynamic monitoring was carried out by performing MRI of the brain and MR venography, and finally an ultrasound examination of the orbit was performed.

Description of a clinical case. The clinical presentation consisted of a slight non-pulsatile unilateral exophthalmos, mild ptosis, periorbital soft tissue edema, subconjunctival hemorrhage, paraorbital hematoma, and venous dysfunction in the fundus. MSCT and MSCT angiography revealed a thrombus inside the sac of orbital venous varicose veins. The disease was probably secondary in nature, given that it was combined with venous angioma of the subcortical region on the same side. During 9 months of observation, to monitor the effectiveness of therapy, MRI was performed three times before and after contrast enhancement, which showed a gradual decrease in exophthalmos, the size of the thrombus and the varicocele sac, which was accompanied by a gradual improvement in the clinical picture until subjective recovery.

Conclusion. MRI was as good an imaging modality as MSCT, and, in our opinion, more preferable due to the absence of radiation exposure and the need for iodine contrast agent.

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