Comparative characteristics of ophthalmological symptoms of orbitocranial and orbital cavernous venous malformation

Abstract

BACKGROUND: Cavernous venous malformation of the orbit, formerly known as cavernous hemangioma of the orbit, refers to vascular malformations with slow blood flow, and is a frequent lesion of the orbit in adults. The spread of cavernous venous malformation of the orbit into the cranial cavity is extremely rare. AIM: The aim of this study is a comparative analysis of ophthalmological manifestations of orbitocranial and orbital cavernous venous malformation. MATERIALS AND METHODS: The analysis was performed on 50 patients operated in N.N. Burdenko National Scientific and Practical Center for Neurosurgery from 2004 till 2023. Two groups of patients with сavernous venous malformation of the orbit were identified: group 1 — with malformation spreading into the cranial cavity, group 2 —with malformation localized in the orbit only. RESULTS: In 29 patients, cavernous venous malformation of the orbit spread into the cranial cavity through superior orbital fissure, inferior orbital fissure, optic canal and/or through combinations thereof; in 21 patients, the malformation was located in the orbit only. Females prevailed in both groups; the average age was 44 years. The first group included patients with the following features: visual impairments were more frequent and more prominent, oculomotor disorders caused mainly by the involvement of oculomotor and abducens nerves; optic nerve atrophy, slight proptosis. The second group was identified by more prominent proptosis, more mild visual impairments, oculomotor disorders caused by the presence of the malformation in the orbit, at the eye fundus, optic nerve head edema prevailed. CONCLUSIONS: Ophthalmic symptoms due to topographic and anatomical variants of a cavernous malformation.