title: Transorbital superior ophthalmic vein sacrifice to preserve vision in ocular hypertension from aseptic cavernous sinus thrombosis.
abstract: Aseptic cavernous sinus thrombosis (CST) is rare and may clinically masquerade as a carotid cavernous fistula. Conventional management includes oral anticoagulation, but cases of ocular hypertension affecting vision may require more aggressive intervention. We report a case of a woman with spontaneous bilaterally occluded cavernous sinuses with elevated intraocular pressure (IOP), which resolved immediately following unilateral superior ophthalmic vein (SOV) sacrifice. She was subsequently placed on oral anticoagulants. By 4 months postoperatively her IOP was normalized and her vision had improved. Repeat angiography demonstrated stable venous filling, with some mild improvement of flow through the cavernous sinus. Coil-mediated sacrifice of the SOV might be an effective means to relieve ocular hypertension and preserve vision in the setting of aseptic CST.
authors.affiliation: Department of Neurosurgery, Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: Travis R
authors.initials: TR
authors.lastname: Ladner
authors.affiliation: Department of Neurosurgery, Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: Brandon J
authors.initials: BJ
authors.lastname: Davis
authors.affiliation: Department of Neurosurgery, Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: Lucy
authors.initials: L
authors.lastname: He
authors.affiliation: Department of Ophthalmology and Visual Sciences, Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: Louise A
authors.initials: LA
authors.lastname: Mawn
authors.affiliation: Department of Neurosurgery, Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: J
authors.initials: J
authors.lastname: Mocco
mesh_terms: D000328:Adult; D001766:Blindness / Q000209:etiology / Q000517:prevention & control*; D020216:Carotid-Cavernous Sinus Fistula / Q000175:diagnosis; D002426:Cavernous Sinus / Q000473:pathology; D020226:Cavernous Sinus Thrombosis / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007429:Intraocular Pressure; D009798:Ocular Hypertension / Q000209:etiology / Q000628:therapy*; D009915:Orbit / Q000098:blood supply*; D014680:Veins / Q000473:pathology*; D014785:Vision, Ocular
keywords: Blood Flow; Coil; Intervention; Orbit; Vein