RT Journal Article
SR Electronic
T1 Transorbital superior ophthalmic vein sacrifice to preserve vision in ocular hypertension from aseptic cavernous sinus thrombosis
JF BMJ Case Reports
FD BMJ Publishing Group Ltd
SP bcr2014011454
DO 10.1136/bcr-2014-011454
VO 2014
A1 Travis R Ladner
A1 Brandon J Davis
A1 Lucy He
A1 Louise A Mawn
A1 J Mocco
YR 2014
UL http://casereports.bmj.com/content/2014/bcr-2014-011454.abstract
AB 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.