An unusual case: Bilateral orbital varices

Abstract

Purpose: To present a rare case of bilateral orbital varices. Methods: An 18-year-old man showing bilateral orbital masses on magnetic resonance (MR) imaging was examined with color Doppler ultrasonography (US), computed tomography (CT) and digital subtraction venography. Results: The presenting symptoms of the patient were pain and fullness in both orbits induced by bending forward. Ocular examination was normal with the exception of a two milimeter proptosis of both eyes during Valsalva maneuver. MR imaging demonstrated bilateral retrobulbar masses, but was not diagnostic. The comparison of CT images obtained before and after Valsalva maneuver revealed the diagnosis of orbital varices. Color Doppler US and orbital venography demonstrated a large venous connection between the lesions and systemic circulation. Conclusion: Clinical presentation of orbital varices is unusual. Different radiological methods may be necessary for the confirmation of the diagnosis and demonstration of the anatomic and the dynamic features of the lesions.