Bilateral corkscrew episcleral veins from tricuspid incompetence.
OBJECTIVE
To use color Doppler imaging in examining a patient with clinically diagnosed low-flow carotid-cavernous sinus fistula and a history of rheumatic heart disease.


METHODS
The flow characteristics of the orbital vessels and the internal jugular veins were studied with a 7.0-MHz transducer.


RESULTS
Episodic arterialization and reversal of blood flow was demonstrated in both superior ophthalmic veins. This similar waveform was also seen in both jugular veins.


CONCLUSIONS
The presence of tricuspid regurgitation and pulmonary hypertension caused increased episcleral venous pressure and the corkscrew appearance, which is more commonly associated with carotid-cavernous sinus fistula.
Fu
E R
ER
Neuro-ophthalmic Service, Singapore National Eye Centre, Singapore.
D001164:Arteriovenous Fistula / Q000150:complications / Q000473:pathology; D001783:Blood Flow Velocity; D002340:Carotid Artery Diseases / Q000150:complications / Q000473:pathology; D002426:Cavernous Sinus / Q000473:pathology; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications; D007601:Jugular Veins / Q000000981:diagnostic imaging; D008875:Middle Aged; D009915:Orbit / Q000098:blood supply*; D012214:Rheumatic Heart Disease / Q000150:complications; D012590:Sclera / Q000098:blood supply* / Q000473:pathology*; D014262:Tricuspid Valve Insufficiency / Q000150:complications*; D018615:Ultrasonography, Doppler, Color; D014680:Veins / Q000000981:diagnostic imaging / Q000473:pathology; D014690:Venous Pressure