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Case Reports: Unusual association of diseases/symptoms
Central vein stenosis: a rare cause of orbital congestion in a haemodialysis patient
  1. Khalilah Mastura Zahari1,2,
  2. Nurul Sakinah Mohamad Hatta1,
  3. Nurul Ain Masnon1,3 and
  4. Li Shyan Ch'ng4,5
  1. 1Department of Ophthalmology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
  2. 2Department of Ophthalmology, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
  3. 3Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, UK
  4. 4Department of Radiology, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
  5. 5Department of Radiology, Faculty of Medicine, UiTM Sungai Buloh, Selangor, Malaysia
  1. Correspondence to Dr Nurul Ain Masnon; aynmasnon{at}gmail.com

Abstract

We report a rare, potentially sight-threatening ocular complication due to central venous stenosis related to a previous site of haemodialysis catheter. A dialysis-dependent woman in her 60s presented with left eye redness for 1 month followed by a remarkably prominent vessel on the left upper eyelid for 2 weeks. Examinations found left eyelid oedema with prominent venous dilatation on the upper eyelid as well as left eye mild proptosis, conjunctiva injection with corkscrew vessels, raised intraocular pressure, and dilated and tortuous retina vessels. Central thoracic venogram showed total occlusion on the left brachiocephalic vein with retrograde reflux to the jugular vein. An endovascular percutaneous transluminal balloon angioplasty was performed for the left brachiocephalic vein stenosis, which resolved the orbital, facial and neck venous congestion. The patient remained asymptomatic after 1 year.

  • dialysis
  • interventional radiology
  • ophthalmology

https://doi.org/10.1136/bcr-2023-254999

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    Footnotes

    • Contributors KMZ and NSMH were contributed to the data acquisition, data analysis, literature search, and manuscript preparation, including the consent taking and obtaining the images. NAM was the physician in charge of the patient, provided important intellectual content for the discussion of the write up of the case presentation and finalised the case report before submission. CLS was the interventional radiologist in charge of the patient, provided expert opinion to co-manage the patient and provided intellectual content for the discussion of the case report.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.