PMC10316230_01
Photographs showing left eye proptosis with chemosis and scleral injection.
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F1
Clinical examination revealed a left proptotic orbit with chemosis and scleral injection [Figure 1].
Axial computed tomography angiogram showing a well-circumscribed soft-tissue mass within the inferior intraconal space of the left orbit measuring 1.8 +- 1.7 cm.
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F2
CT angiogram revealed a well-circumscribed heterogeneously enhancing mass within the inferior intraconal space of the left orbit (measuring 1.8 x 1.7 cm round) with periorbital soft-tissue swelling, suggesting inflammation [Figure 2].
Magnetic resonance imaging angiogram axial (a), coronal (b), sagittal, and (c) showing hyperdense left inferior intraconal hyperdense well-circumscribed mass in the left orbit.
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F3
Magnetic resonance imaging (MRI) angiogram confirmed the findings of past studies: orbital cellulitis was apparent, the left inferior ophthalmic vein was prominent as compared to the right, and there was a partly thrombosed venous varix of the inferior ophthalmic vein [Figure 3].
Diagnostic cerebral angiogram showing intraconal venous varix (arrows point) measuring 8 mm in diameter.
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F4
To further delineate the nature of the lesion, a diagnostic cerebral angiogram was performed, which revealed an intraconal venous varix [Figure 4].
Photograph of the patient at the follow-up visit showing the absence of chemosis and scleral injection with mild proptosis in the left eye.
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F5
On examination, there was no chemosis or scleral injection, but there was a significantly improved mild, painless proptosis [Figure 5].
Two weeks follow-up computed tomography orbit with contrast showing stable soft-tissue intraconal mass in the left orbit with central enhancement in consistent with the previously diagnosed thrombosed orbital varix.
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F6
A 2-week follow-up CT scan of the orbit with contrast demonstrated a stable soft-tissue intraconal mass in the left orbit with peripheral venous phase enhancement in addition to central enhancement, consistent with the previously diagnosed thrombosed orbital venous varix of the inferior ophthalmic vein [Figure 6].
One-year orbital magnetic resonance imaging follow-up without contrast, showing a slight increase of the intraconal mass size in the left orbit.
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F7
A 1-year orbital MRI was conducted and showed a slight increase in the enhancing intraconal mass in the left orbit [Figure 7].