PMC5778557_01
(a and b) External photographs illustrate left periorbital ecchymosis, subconjunctival hemorrhage, and dilated and tortuous episcleral veins; (c) external photograph with worm's eye view reveals left eye proptosis; (d) coronal reconstruction; and (e) axial section of the venous phase of computed tomography angiography shows dilated left superior ophthalmic vein thrombosis (white arrowhead) and enlarged extraocular muscles (*); (f) a more inferior axial section illustrates a normally opacified symmetric cavernous sinuses without any filling defect to suggest thrombosis. (g and h) External photographs at 8-week follow-up
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F1
In the left eye, there was periorbital ecchymosis, diffuse conjunctival congestion, subconjunctival hemorrhage, and episcleral vascular engorgement and tortuosity [Fig. 1a and b]. On Hertel's exophthalmometry, a 4 mm axial proptosis left eye was noted [Fig. 1c]. A dual phase CT angiography of the brain and orbits showed that the cavernous sinuses were symmetrical in appearance with no early arterial phase opacification of either the cavernous sinuses or the SOVs, with a clear-cut filling defect in the enlarged left SOV in the venous phase [Fig. 1d-f]. Gradual resolution of symptoms was noted, and the vision was preserved at 20/20 both eyes at 8-week follow-up [Fig. 1g and h].