Risk factors for visual loss after excision of apical orbital cavernous venous malformations

Excision of orbital cavernous venous malformations (OCVMs, “cavernous haemangiomas”), as with all orbital surgery, carries a risk of visual loss, and clinico-radiological features may provide an estimate of this risk. Awareness of this risk is necessary for clinical decision-making when planning surgery, radiotherapy or observation, and facilitates an informed consent. Endoscopic endonasal approaches for excision of OCVMs are increasingly performed, but visual outcomes are under-reported. We outline some important considerations in assessing the risk of visual loss after excision of OCVMs, with particular regard to endoscopic endonasal approaches.