[Digital subtraction phlebography of the orbit. Technic and diagnostic value]

Orbital venography in the diagnostic assessment of vascular and extravascular expanding lesions of the orbit has been almost abandoned during the last decade due to the rapid development of computed tomography, ultrasound echography, and magnetic resonance imaging. Digital subtraction angiography (DSA) is a new angiographic modality that has recently replaced conventional techniques. DSA saves time and contrast media while facilitating vascular imaging and processing; this decreases the invasiveness of angiographic procedures. We describe the technique used for orbital phlebography via puncture of a frontal vein and injection of a contrast medium during manual compression of the infraorbital veins. We present the history and diagnostic findings of a 21-year-old man suffering from an orbital varix and discuss the diagnostic value of digital subtraction phlebography. In summary, the application of digital subtraction techniques is recommended as an additional diagnostic modality, particularly when impaired venous perfusion of the orbit is suspected.