Thrombose der Vena ophthalmica superior – Fallserie und Literaturübersicht

Thrombosis of the superior ophthalmic vein (SOV) is rare. It can present with heterogeneous symptoms and requires a careful diagnostic work-up.

This article reports on a case series of three female patients with thrombosis of the SOV and performed an extensive review of the existing literature in PubMed.

All three patients showed different leading symptoms but all had a triad of restricted eye motility, exophthalmos and a difference in intraocular pressure with the higher pressure on the side of the protruded eyeball. The pathophysiological background differed in all cases: in the two first cases a pre-existing anticoagulation treatment had been paused shortly before the event. Cofactors were an intraorbital venous outflow obstruction due to an unclear mass in the orbital apex in one case and hypercoagulability due to a malignant disease in the other case. In the third case, there was a cavernous sinus fistula.

The diagnosis should be considered not only in patients with dilated vessels of the anterior segment but also in unclear cases of exophthalmos or unilateral elevated intraocular pressure (IOP).