Classification and treatment of orbital venous malformations: an updated review

doi:10.1007/s11684-018-0623-2

Front. Med.

2019, Vol. 13

Issue (5) : 547-555 https://doi.org/10.1007/s11684-018-0623-2

REVIEW

Classification and treatment of orbital venous malformations: an updated review

Tianyuan Li, Renbing Jia, Xianqun Fan(

)

Department of Ophthalmology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China

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Abstract

Orbital venous malformation (OVM) is a congenital vascular disease. As a common type of vascular malformation in the orbit, OVM may result in vision deterioration and cosmetic defect. Classification of orbital vascular malformations, especially OVMs, is carried out on the basis of different categories, such as angiogenesis, hemodynamics, and locations. Management of OVM is complicated and challenging. Treatment approaches include sclerotherapy, laser therapy, embolization, surgical resection, and radiotherapy. A satisfactory outcome can be achieved only by selecting the appropriate treatment according to lesion characteristics and following the sequential multi-method treatment strategy. This article summarizes the current classification and treatment advances in OVM.

Keywords orbit venous malformation treatment sclerotherapy laser embolization

Corresponding Author(s): Xianqun Fan

Just Accepted Date: 25 April 2018 Online First Date: 10 August 2018 Issue Date: 14 October 2019

Cite this article:

Tianyuan Li,Renbing Jia,Xianqun Fan. Classification and treatment of orbital venous malformations: an updated review[J]. Front. Med., 2019, 13(5): 547-555.

URL:

https://academic.hep.com.cn/fmd/EN/10.1007/s11684-018-0623-2
https://academic.hep.com.cn/fmd/EN/Y2019/V13/I5/547

Fig.1 Stratified three-grade classification of orbital vascular lesions.

Fig.2 Treatment strategy of non-distensible OVM. For superficial lesions, if puncture shows positive blood flow return, then sclerotherapy followed or not followed by surgical resection is the first-line treatment; if puncture shows negative blood flow return, then surgical excision or laser is an appropriate treatment. For deep extraconal lesions, sclerotherapy combined with surgical procedures is primarily considered. For deep intraconal lesions, navigation-assisted sclerotherapy is preferred.

Fig.3 Treatment strategy of distensible OVM. For superficial lesions, physicians can select surgical procedures combined with either sclerotherapy or laser. For deep extraconal lesions, sclerotherapy combined with surgical excision or surgical exposure followed by intralesional and excision is the first line treatment. For deep intraconal lesions, which are challenging in orbital surgery, navigation-assisted sclerotherapy is preferred.

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