A possible new etiology for ophthalmic varicose veins: disseminated intracranial hyperostosis

Abstract

We wanted to see if cranial anatomical altera-tions could influence the vascularization of the eyeball, particularly in the production of ophthalmic varicose veins. Orbital dissection of 85 years old woman (who suffered from Alzheimer’s disease and respiratory failure). We observed, when performing a horizontal sec-tion of the skull to access the roof of the orbit, that the intracranial surface of the anterior and middle cranial fossae was partially covered by bony out-growths, with the optical aperture and superior or-bital fissure included. Also, when removing the roof of the orbits and beginning to extract the orbital fat we saw a dark, bilateral mass in the upper part of the orbital cavity corresponding to very dilated ves-sels. Bone alteration of the internal face of the skull was a diffuse intracranial hyperostosis and the dark dilated masses were superior ophthalmic varicose veins. Our hypothesis is that the origin of these ophthal-mic varicose veins was the narrowing of the supe-rior orbital fissure due to excessive bone prolifera-tion. Intracranial hyperostosis produces a difficulty in draining orbital venous blood and, consequently, venous dilation. For this reason, we should consid-er this in the differential diagnosis.