Orbital varices: Epidemiology, clinical presentation, and treatment outcomes – A scoping review

Abstract

Orbital varices are vein dilations in the orbit presenting various symptoms. This scoping review synthesizes existing evidence on their epidemiology, clinical features, and treatment efficacy. Literature was reviewed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed and Scopus were searched until April 31, 2024, for articles on clinically diagnosed ocular varices detailing diagnostic methods, treatments, and outcomes. Exclusions were reviews, animal studies, and incomplete case reports. Data on study characteristics, diagnosis, management, and outcomes were extracted and assessed for quality and bias. Eight studies met the inclusion criteria, with sample sizes ranging from 4 to 30 and ages from 1 to 87 years. Diagnostic tools included magnetic resonance imaging and computed tomography, while treatments ranged from conservative methods to invasive procedures and radiosurgery. Notably, higher symptom resolution rates were associated with observational strategies and minimally invasive surgeries. However, Gamma Knife radiosurgery, although promising, posed risks of vision impairment in some cases. The management of orbital varices has evolved significantly with newer, less invasive techniques improving outcomes and reducing recovery times. Despite advancements, challenges such as disease recurrence and the need for personalized treatment regimens persist, underscoring the ongoing need for research to refine and standardize treatment approaches.