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2.1
Orbital Varix
Varices Orbit

Presentation

AU - Kahana,Alon PY - 2016/8/1 Y1 - 2016/8/1 N2 - An orbital venous varix is rare and can present with diplopia, proptosis, or hemorrhage. [experts.umich.edu]

Classically, they present in the 2nd and 3rd decade of life and occur equally in males and females (Rubin). Presenting symptoms are typically intermittent diplopia or proptosis during of straining or prone position. [radiopaedia.org]

We report the case of a 71-year-old male who presented with the acute onset of a cystic mass below the right inner canthus and associated vertical diplopia. [jhu.pure.elsevier.com]

Entire Body System

  • Soft Tissue Mass

    A CT scan of the orbits demonstrated a serpiginous soft tissue mass within the superior portion of the right orbit, consistent with a thrombosed orbital varix. Conservative management was agreed with prism glasses and ophthalmological follow-up. [ncbi.nlm.nih.gov]

    A magnetic resonance imaging (MRI) scan showed a serpiginous superior orbital mass having a vascular communication to the subcutaneous soft tissue mass on the temple ( Figure 1 ). [nature.com]

    Fine cut contrast-enhanced CT scans usually show ill-defined, heterogeneous multiloculated enhancing soft tissue mass(es) with connections to the orbital and extraorbital circulation. [surgicalneurologyint.com]

  • Fishing

    Selenium is found in foods including nuts, meats, fish, poultry, eggs, dairy products and whole grains. Typically, diet alone provides more than the recommended dietary allowance of 55 mcg. [articles.chicagotribune.com]

  • Turkish

    Hacettepe University School of Medicine Department of Radiology, Ankara, Turkey Thorac Res Pract 2001; 2: Turkish Respiratory Journal 26-27 Read: 194 Downloads: 145 Published: 07 October 2021 Volume 2, Issue 1, May 2001 Orbital varix is an uncommon vascular [turkthoracj.org]

Respiratoric

  • Pleural Effusion

    X-ray imaging obtained in the emergency department demonstrated bilateral pleural effusions. Our patient was admitted subsequently for an exacerbation of congestive heart failure. She was monitored for euvolemia and discharged 4 days later. [mdedge.com]

  • Hypercapnic Respiratory Failure

    We present a patient with chronic obstructive pulmonary disease complaining about painless proptosis in his right eye which occurred during acute hypercapnic respiratory failure. [turkthoracj.org]

Skin

  • Cutaneous Manifestation

    A 57-year-old woman with cutaneous manifestations of (BRBNS) presented with acute left proptosis and venous congestion secondary to thrombosis within a superior ophthalmic vein varix. [ncbi.nlm.nih.gov]

Workup

Diagnosis, Workup and Treatment The presentation of painless proptosis in a teenager can represent infectious, inflammatory or neoplastic processes. [reviewofophthalmology.com]

[…] this workup is completed and negative may the patient be considered to have idiopathic elevated EVP. [eyewiki.org]

Laboratory workup was negative aside from positive toxoplasma IgG antibodies. [ncbi.nlm.nih.gov]

Another presentation that should prompt an orbital varix workup is enophthalmos. Imaging should be obtained to assist with diagnosis, however the varices may not be seen if they are not distended, so valsalva maneuvers should be employed. [eyewiki.aao.org]

Serum

  • Hypercapnia

    Right severe hypercapnia with a partial arterial carbon dioxide pressure (PaCO2) of 73 mm Hg and severe hypoxaemia with a partial arterial oxygen pressure (PaO2) of 40.3 kPa. The other laboratory findings were normal except a hematocrit of 57%. [turkthoracj.org]

Pleura

  • Pleural Effusion

    X-ray imaging obtained in the emergency department demonstrated bilateral pleural effusions. Our patient was admitted subsequently for an exacerbation of congestive heart failure. She was monitored for euvolemia and discharged 4 days later. [mdedge.com]

Treatment

Because orbital varix treatment is the treatment of a rare vascular orbital tumor disease, chances are that only a few doctors like Dr. Debraj Shome at The Esthetic Clinics will be available with experience in orbital varix treatment. [oculoplastic-eyelid-orbit-surgery.com]

There are no well established guidelines for treatment. Treatment is individually tailored to the patient. [rareguru.com]

Treatment can be challenging, especially if the varix is in a posterior location within the orbit, since surgical exposure becomes difficult. [experts.umich.edu]

Active treatment of orbital varix may, therefore, be important, and development of a suitable form of treatment is desirable. [ijo.in]

Prognosis

Prognosis Prognosis is good in most patients with primary orbital varix. Recurrence after subtotal excision is an issue of concern. Most patients remain stable without evidence of re-bleeding. [nhp.gov.in]

[…] particular pathologic process - Classic Clues sum up pathologic processes and indicate when you can expect to see those findings - Content snapshots get to the point, including fast facts, epidemiology and pathology, data overviews on treatment and prognosis [books.google.com]

[…] hypointense cf. extraocular muscles If thrombosis is present the imaging is more variable: T1: heterogeneous with areas of high signal (see aging of blood on MRI) T2: heterogeneous with areas of high signal (see aging of blood on MRI) Treatment and prognosis [radiopaedia.org]

Etiology

The patient had sustained facial trauma two years previously and a post-traumatic etiology is postulated. [jhu.pure.elsevier.com]

The etiology of this unusual clinical manifestation and the treatment of the patient are briefly discussed. [ncbi.nlm.nih.gov]

Courtesy of Michael Migliori, MD Etiology Orbital varices are venous malformations of the orbit, vascular hamartomas. [1] [2] They consist of a plexus of thin-walled distensible low flow vein-like vessels that are commonly intrinsic to the normal circulation [eyewiki.aao.org]

Epidemiology

[…] important: - Key Chapter Points give a "bird’s eye view" of a particular pathologic process - Classic Clues sum up pathologic processes and indicate when you can expect to see those findings - Content snapshots get to the point, including fast facts, epidemiology [books.google.com]

Epidemiology: Orbital varix, being a very uncommon condition, constitutes for approximately 1.3% of all orbital tumours. [oculoplastic-eyelid-orbit-surgery.com]

Michael Migliori, MD Etiology Orbital varices are venous malformations of the orbit, vascular hamartomas. [1] [2] They consist of a plexus of thin-walled distensible low flow vein-like vessels that are commonly intrinsic to the normal circulation. [3] Epidemiology [eyewiki.aao.org]

Definition, epidemiology and pathogenesis of hPIDs Primary Immunodeficiencies (PIDs) are genetically determined conditions characterized by impaired development and/or functioning of the immune system. [posterng.netkey.at]

Pathophysiology

The clinical, radiographic, surgical, and histopathologic features of this entity are described and discussed and a hypothesis is proposed to explain the pathophysiology of orbital varix thrombosis. [ncbi.nlm.nih.gov]

The pathophysiology of these latter headaches could be related to congestion and dilation of cerebral venous sinuses and large veins [ 6 ]. We present a postural headache related to an orbital varix. [jneuro.com]

The pathophysiology of these latter headaches could be related to congestion and dilation of cerebral venous sinuses and large veins [6]. We present a postural headache related to an orbital varix. [itmedicalteam.pl]

Prevention

The treatment is rather conservative and/or preventive of complications. Preventive low-dose anticoagulation can be discussed in patients without contraindications, to avoid thrombosis. [ncbi.nlm.nih.gov]

Prevention There are unfortunately preventive measures. [gavazzeni.it]

Supported by Research to Prevent Blindness, Inc, New York, New York. The funding organization had no role in the design or conduct of this research. [experts.umn.edu]

Patient care Bleeding esophageal varices constitute a medical emergency, requiring immediate treatment to control hemorrhage and prevent hypovolemic shock. [medical-dictionary.thefreedictionary.com]

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