Orbital Vascular Malformation in the Venous System (Orbital Varices)
Jochem T., Lieb W.
Dept. of Ophthalmology, University Wuerzburg
Purpose: In 1998 a new classification of orbital vascular malformations, according to their haemodynamic relationship, was introduced by the Orbital Society. Classification is made into vascular malformations with no flow, venous flow, and arterial flow. In particular the group of venous malformations is often clinically misunderstood. Therefore we analysed retrospectively patients with this disorder in our institute.
Method: We identified retrospectively seven patients (3 male, 4 female) with vascular venous orbital malformation in the years 1995 to 2003. Symptoms, diagnosis, therapy and clinical procedure was documented. Patients were 3 months to 58 years of age (mean 38,3 years).
Results: An intermittent exophthalmos was the clinically main presenting symptom in all patients. Three patients had enlarged episcleral vessels, two patients complained about intermittent diplopia. The majority of patients had a feeling of pressure or dull pain when changing position. In all patients the diagnosis could be verified by A- and B-scan ultrasonography or colour Doppler imaging. Five patients were continuously observed; in two patients an excision of the varix was performed.
Conclusions: Venous malformations must be distinguished from arterial or venous-lymphatic malformations. Intermittent exophthalmos is a typical clinical symptom. Modern ultrasonography is a non invasive and uncomplicated device for the diagnosis. In case of surg
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