Programm                 "Degeneration und Regeneration– Grundlagen, Diagnostik und Therapie"

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Vascular Malformations of the Orbit - Classification, Clinical Findings and Therapeutic Options

Lieb W.
Augenklinik der Julius-Maximilians-Universität Würzburg und der St. Vincentius-Kliniken Karlsruhe

Understanding vascular lesions of the orbit requires a familiarity with a number of embryologic, pathophysiologic and hemodynamic concepts that influence their behaviour, clinical features and treatment strategies. The normal embryologic and anatomy of the vascular system strongly influences their type and development. It is important to differentiate between new growth and malformation. Malformations tend to have flat in endothelial cells, do no grow in vitro and have dysplastic vessels. Malformations tend to be diffuse and maybe associated with irregular vessels and focal calcifications. The vascular malformations need to be differentiated from aquired arterio-venous shunts or fistulae. They do either arise from the arterial, venous system or both. The orbital society has a classification of orbital vascular malformations based on their hemodynamic relationships. This classification promotes clinical differentiation based on blood flow. On the basis of clinical features, doppler results and MRI-scanning, orbital vascular malformations can be categorized into the following. Type 1: no flow (hemodynamically isolated), Type 2: venous flow, Type 3: arterial flow. Furthermore lymphatic and combined venous Lymphatic vascular malformations have to be distinguished. In addition aquired arterio-venous shunts so called dural cavernous sinus fistulae or cartorid-cavernous sinus-fistulae can be seen. A

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