Orbital ultrasonography for diagnosis and evaluation of retrobulbar vascular disorders

Abstract

Diagnostic and differential diagnostic of orbital diseases are considered to be one of the most difficult problems in ophthalmology because most orbital pathologies display the same signs and symptoms. Condition of orbital tissues can be evaluated using three different radiology imaging techniques: A/B-scan ultrasonography, computed tomography, and magnetic resonance imaging. A/B-scan ultrasonography is highly informative, non-invasive and poses no risk on the patient, therefore may be repeatedly performed in order to evaluate treatment effectiveness or disease progression. Ultrasonography has become an extremely useful tool in assesment of orbital vascular disorders. Orbital vascular disorders are divided into two main groups: neoplasms and malformations. Vascular malformations are: cavernous sinus fistula, carotid-cavernous sinus fistula, dural-cavernous sinus fistula, superior ophthalmic vein thrombosis, orbital varix, arteriovenous malformation and orbital aneurysm. In this article, we present the case of a difficult superior ophthalmic vein thrombosis in which orbital ultrasonography imaging was used in confirming the diagnosis and evaluating treatment effectiveness.