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Type: Journal article
Title: Orbital Arteriovenous Malformations
Author: Warrier, S.
Prabhakaran, V.
Valenzuela, A.
Sullivan, T.
Davis, G.
Selva-Nayagam, D.
Citation: JAMA Ophthalmology, 2008; 126(12):1669-1675
Publisher: Amer Medical Assoc
Issue Date: 2008
ISSN: 0003-9950
Statement of
Sunil Warrier, Venkatesh C. Prabhakaran, Alejandra Valenzuela, Tim J. Sullivan, Garry Davis and Dinesh Selva
Abstract: <h4>Objective</h4>To present the clinical features, management, and outcomes in a series of patients with orbital arteriovenous malformations (AVMs).<h4>Methods</h4>Clinical records of patients with orbital AVMs confirmed using angiography were reviewed as a retrospective, noncomparative, interventional case series.<h4>Results</h4>Eight patients (3 women and 5 men) with unilateral AVMs and a mean age of 39 years (median, 36.5 years; range, 26-70 years) were reviewed. Findings existed for an average of 11.2 years before diagnosis and included periocular mass (7 patients, 88%); periocular edema, pulsation/bruit, proptosis, episcleral congestion, and previous trauma (4 patients each, 50%); elevated intraocular pressure (3 patients, 38%); pain and reduced visual acuity (2 patients each, 25%); and restriction of extraocular movements, and diplopia (1 patient each, 12%). All of the patients except 1 underwent surgical resection, with 3 (38%) receiving preoperative embolization of feeder vessels; all of the patients had initial resolution of manifestations after treatment.<h4>Conclusions</h4>Angiography is essential for diagnosis and for planning the management of orbital AVMs. Treatment depends on patient-specific features and includes observation, embolization, and surgical excision or combined preoperative embolization/excision. Given their vascular nature, the main cause of poor management outcomes is perioperative hemorrhage. Outcomes after a multidisciplinary approach are good, with few recurrences reported at follow-up.
Keywords: Face
Carotid Artery, External
Ophthalmic Artery
Arteriovenous Malformations
Tomography, X-Ray Computed
Magnetic Resonance Imaging
Fluorescein Angiography
Embolization, Therapeutic
Retrospective Studies
Middle Aged
Description: Copyright © 2008 American Medical Association. All rights reserved.
DOI: 10.1001/archophthalmol.2008.501
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