Bleomycin sclerotherapy of a distensible orbital venous malformation without image guidance
Ying Chen, Catherine J. Choi, Bradford W. LeeRead More
An orbital varix is a distensible venous malformation consisting of vascular channels that directly communicate with the systemic venous system. It can present with variable pain, proptosis, diplopia, spontaneous hemorrhage, or even vision loss, and these symptoms typically worsen with Valsalva maneuver. Treatments proposed include vascular clipping, endovascular glue embolization, endovascular coiling, surgical resection, or combination therapy.1 Recurrence is common, however, and devastating visual complications can occur with procedural interventions such as surgical resection and endovascular procedures.2 Previous reports of using bleomycin sclerotherapy to treat vascular malformations have focused on lymphatic venous malformations, cavernous hemangiomas, and high- and low-flow orbital venous malformations.3, 4 There is only one previous case report of bleomycin sclerotherapy used to treat an orbital varix, and this case utilized angiography-guided catheterization through the cavernous sinus, a microcatheter balloon, and contrast-enhanced sclerotherapy mixed with bleomycin.5 Here the authors describe the first reported case of non-image-guided bleomycin sclerotherapy for treatment of an orbital varix.