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Bilateral corkscrew episcleral veins from tricuspid incompetence
1Neuro-ophthalmic Service, Singapore National Eye Centre, Singapore.
Purpose:
To use color Doppler imaging in examining a patient with clinically diagnosed low-flow carotid-cavernous sinus fistula and a history of rheumatic heart disease.
Method:
The flow characteristics of the orbital vessels and the internal jugular veins were studied with a 7.0-MHz transducer.
Results:
Episodic arterialization and reversal of blood flow was demonstrated in both superior ophthalmic veins. This similar waveform was also seen in both jugular veins.
Conclusion:
The presence of tricuspid regurgitation and pulmonary hypertension caused increased episcleral venous pressure and the corkscrew appearance, which is more commonly associated with carotid-cavernous sinus fistula.