PMC7849855_01
A photograph showing: (a) Right periorbital swelling with mild erythema, ecchymosis, subconjunctival hemorrhage, dilated and tortuous episcleral veins; (b and c) showed a restricted ocular motility
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F1
The ocular motility examination showed a total right ophthalmoplegia [Figure 1].
Computed Tomography Scan of the orbits: (a) axial section, (b) coronal reconstruction of the venous phase of computed tomography angiography: The arrow is pointing to dilated right superior ophthalmic vein thrombosis and enlarged extraocular muscles
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F2
Suspecting an intraocular malignancy with orbital involvement, an urgent CT scan of the orbits was performed [Figure 2].
Brain MRI (T1 Gadolinium-enhanced): (a) axial section, (b and d), coronal section, (c) sagittal section: the arrow is pointing to right SOVT, (b) T1 coronal section: the arrow is pointing to the partial extension of thrombus into the right cavernous sinus
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F3
CT and MRI angiograms excluded a dural cavernous sinus fistula, a sino-orbital infection, but showed a partial extension of thrombus into the ipsilateral cavernous sinus [Figure 3].
External photographs at 1-week follow-up; (b and c): no limitation of ocular motility
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F4
Evolution was marked ultimately by the gradual disappearance of symptoms 1 week after starting anticoagulation therapy [Figure 4].