目的:眼静脉血栓形成(SOVT)是一种极为罕见的疾病。关于这种情况的临床方面的研究很少发表。在这项研究中,我们研究了症状,潜在病因,治疗,SOVT的发病机制和并发症,我们试图根据病因对其进行分类,治疗,和预后。
方法:我们回顾了来自三级学术转诊中心的患者数据。然后对每位SOVT患者进行与SOVT相关的症状检查,潜在的病因,治疗方案,治疗反应,并发症,可能的病原体,和最终结果。
结果:本研究包括24例SOVT。总的来说,13例诊断为右侧SOVT,其中,8例同时右侧海绵窦血栓形成(CST).18例诊断为左侧SOVT,其中,11同时具有左侧CST。
结论:SOVT可能是不同机制的次要因素。继发于创伤的SOVT,最近的手术和凝血病大多是非侵袭性的,并且可以通过保守治疗和抗凝治疗来管理。眼眶蜂窝织炎患者的SOVT,活动性鼻窦炎或鼻旁窦手术史表现为急性眼眶肿胀,脓肿和视力丧失。这种类型的SOVT可以通过延伸到海绵窦和颅内结构而复杂化。这些患者需要紧急抗生素治疗和鼻窦手术。最严重的SOVT是由毛霉菌病引起的,毛霉菌病也可能在颅内延伸,导致中风,并且经常危及生命。
OBJECTIVE: Superior ophthalmic vein thrombosis (SOVT) is an extremely rare condition. Few studies have been published about clinical aspects of this condition. In this study, we have studied the symptoms, underlying etiologies, treatment, pathogenesis and complication of the SOVT and we tried to classify it based on the etiology, treatment, and prognosis.
METHODS: We reviewed the patients\' data from a tertiary academic referral center. Each patient with SOVT was then reviewed for symptoms associated with SOVT, underlying etiology, treatment protocol, treatment response, complications, possible pathogens, and final outcome.
RESULTS: Twenty-four cases of SOVT were included in this study. Overall, 13 cases were diagnosed as right-sided SOVT, out of which, eight had simultaneous right-sided cavernous sinus thrombosis (CST). Eighteen cases were diagnosed to have left-sided SOVT, out of which, 11 had simultaneous left-sided CST.
CONCLUSIONS: The SOVT can be secondary to different mechanisms. The SOVT secondary to trauma, recent surgery and coagulopathy are mostly non-aggressive, and can be managed by conservative therapy and anticoagulation. The SOVT in patients with orbital cellulitis, history of active sinusitis or paranasal sinus surgery are aggressive presenting with acute orbital swelling, abscess and visual loss. This type of SOVT can be complicated by extension to the cavernous sinus and intracranial structures. These patients require urgent antibiotics therapy and sinus surgery. The most severe type of SOVT is caused by mucormycosis which may also extend intracranially resulting in stroke and is often life-threatening.