Supplementary Material for: Intermittent Orbital Pain due to Hemodynamic Collapse of an Orbital Varix: A Case Report

Introduction: Orbital varices typically present with symptoms related to dilation or thrombosis. We describe a rare presentation of an orbital varix with pain caused by hemodynamic collapse of the varix. Case description: A woman in the third decade presented with position-dependent orbital pain and enophthalmos. She was found to have an intraorbital varix and a separate pterygoid varix. The patient underwent endovascular treatment of the pterygoid varix using coils and sclerosing agents which altered the venous outflow from the orbital varix. The patient had immediate resolution of symptoms after the procedure. Conclusions: Our findings suggest that extraorbital venous outflow abnormalities may be the cause of symptoms in select cases of orbital varices. By understanding the venous structures on cerebral angiography and treating the extraorbital component, orbital intervention may be avoided, reducing the risk of complications.

引言：眼眶静脉曲张(orbital varices)通常以静脉扩张或血栓形成(thrombosis)相关症状为主要临床表现。本文报道一例罕见病例，该患者的眼眶静脉曲张疼痛由曲张静脉的血流动力学塌陷(hemodynamic collapse)引发。
病例报告：一名二十余岁女性患者，表现为体位相关性眼眶疼痛及眼球内陷(enophthalmos)。影像学检查提示其同时存在眶内静脉曲张(intraorbital varix)与独立的翼状静脉曲张(pterygoid varix)。患者接受翼状静脉曲张血管内治疗(endovascular treatment)，术中采用弹簧圈(coils)与硬化剂(sclerosing agents)改变了眼眶静脉曲张的静脉流出道(venous outflow)。术后患者症状即刻完全缓解。
结论：本研究结果显示，在部分特定眼眶静脉曲张病例中，眶外(extraorbital)静脉流出道异常可能是其症状的致病诱因。通过脑血管造影(cerebral angiography)明确静脉解剖结构，并针对眶外病变进行干预，可避免眼眶介入治疗(orbital intervention)，从而降低并发症(complications)发生风险。