Ophthalmic Vein Thrombosis Associated with Factor V Leiden and MTHFR Mutations

Superior ophthalmic vein thrombosis (SOVT) is a rare clinical entity that may be associated with hypercoagulability status. We present a case of a 77-year-old woman who presented to the emergency department complaining of eye ptosis, chemosis and conjunctival congestion in the right eye (RE). The op...

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Published inDiagnostics (Basel) Vol. 13; no. 6; p. 1052
Main Authors Teodoru, Cosmin Adrian, Munteanu, Mihnea, Mercea, Nadina, Moatar, Alina, Stanca, Horia, Popescu, Florina Georgeta, Dura, Horațiu, Hașegan, Adrian, Giurgiu, Doina Ileana, Cerghedean-Florea, Maria-Emilia
Format Journal Article
LanguageEnglish
Published Switzerland MDPI AG 01.03.2023
MDPI
Subjects
Antibiotics
Anticoagulants
Autoimmune diseases
Blood clot
Blood coagulation factors
Case studies
Cellulitis
Conflicts of interest
Diagnosis
Etiology
Eye diseases
Factor V Leiden
Genetic aspects
Health aspects
Health risk assessment
Hematology
Homocysteine
hyperhomocysteinemia
Inflammation
Interesting Images
Medical imaging
MTHFR mutations
Mutation
Mutation (Biology)
ophthalmic vein thrombosis
Optics
Pathology
Patients
Steroids
Thrombosis
Tomography
Veins & arteries
Visual acuity
Romania
ophthalmic vein thrombosis
hyperhomocysteinemia
Factor V Leiden
MTHFR mutations
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Summary:Superior ophthalmic vein thrombosis (SOVT) is a rare clinical entity that may be associated with hypercoagulability status. We present a case of a 77-year-old woman who presented to the emergency department complaining of eye ptosis, chemosis and conjunctival congestion in the right eye (RE). The ophthalmological examination revealed best-corrected visual acuity (BCVA) was 0.5 for the right eye (RE) 0.5 and 0.06 for the left eye (LE). Intraocular pressure (IOP) was 25 mmHg in RE and 14 mmHg in LE. Non-contrast computed tomography (CT) of the brain and orbits revealed a hyperreflectivity at the level of the right ophthalmic vein and inferior rectus muscle hypertrophy. An extensive hypercoagulable panel was completed and we found a positive result for Factor V Leiden (heterozygous mutation) and methyl-enetetrahydrofolate reductase (MTHFR-C677T homozygous mutations). Systemic steroidal anti-inflammatory and anticoagulant treatments were started immediately. Gradual resolution of symptoms was noted during the hospitalization, and BCVA in her RE was established at 0.7 at the 10-week follow-up.
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ISSN:2075-4418
2075-4418
DOI:10.3390/diagnostics13061052