PMC9987633_01
- Clinical photograph showing A) progressive proptosis of the left eye associated with upper lid swelling and conjunctival chemosis, B) Resolved proptosis, motility limitation, and dilated episcleral vessels. C) Fundus photo of both eyes showing normal appearance
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F1
On admission, an ophthalmologic examination revealed significant dilation of the conjunctival vessels, chemosis, and exophthalmos of the left eye, as well as a significant loss in visual acuity (Figures 1A & 1B). Both fundi were normal (Figure 1C). The fundoscopy images of both eyes (Figures 1A & 1B) are shown respectively. Without medication, IOP in his right eye was 16 mm Hg OD and 18 mm Hg OS in his left eye, and his visual acuity was 0.8 OS after 2 months (Figures 1A & 1B).
- CT angiogram showing A & B) early opacification of left ophthalmic vein (white arrow) through small ophthalmic artery (curved arrow) and the contrast confined to the enlarged torturous superior ophthalmic vein with lack of opacification within the proximal and distal vein (red arrow) representing thrombosed varix
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F2
- Digital subtraction angiogram of carotid artery showing A) early faint filling of the superior ophthalmic vein. B) Late arterial phase clear opacification of arteriovenous fistula. C & D) Venous phase shows Tortuous dilated superior of the ophthalmic vein.
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F3
The DSA of the carotid artery (Figure 3) shows early faint filling of the superior ophthalmic artery, late arterial-phase opacification of arteriovenous fistula, and venous phase shows tortuous dilated superior of the ophthalmic vein.
- Patient's timeline.
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F4
Patient's timeline was summarized in Figure 4.