Fluoroscopic intralesional injection with pingyangmycin lipiodol emulsion for the treatment of orbital venous malformations

OBJECTIVE. The objective of our study was to evaluate the efficacy and safety of percutaneous intralesional injection under fluoroscopy with pingyangmycin Lipiodol emulsion (PLE) for the treatment of orbital venous malformations. MATERIALS AND METHODS. This study is a retrospective analysis of 19 consecutive patients with distensible orbital venous malformations. Of the 19 patients, two had diffuse lesions. These patients presented with proptosis (n = 19), pain and orbital swelling (n = 11), reduction in visual acuity (n = 4), diplopia (n = 2), disk swelling (n = 5), and motility disturbance (n = 3). RESULTS. All 19 patients underwent technically successful percutaneous intralesional PLE injection under fluoroscopy. Complete resolution of proptosis, swelling, and pain was achieved in 17 patients 3-9 months after the procedure. In the other two patients with diffuse lesions, light proptosis was still present after the first procedure. A second procedure was performed in these two patients, and the symptom disappeared 3 months later. All four patients with reduced visual acuity recovered their vision, and diplopia in two patients disappeared. Examinations of the fundus revealed normal findings in the five patients with preprocedural disk swelling. None of the patients presented with a motility disturbance after the procedure. Local swelling in the eyelid and epiphora were present for 1 month in one patient and disappeared after treatment. No other complications, including acute orbital compartment syndrome, were observed during follow-up periods. The mean follow-up was 23 months. CONCLUSION. PLE sclerotherapy under fluoroscopic guidance is safe and effective for the treatment of orbital venous malformations and can be used as one of the treatment alternatives.