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The following is a summary of “Risk factors for visual loss after excision of orbital cavernous venous malformations: a systematic review,” published in the January 2025 issue of Ophthalmology by Pietris et al.
Researchers conducted a retrospective study to identify risk factors for vision loss associated with the excision of orbital cavernous venous malformations (OCVMs).
They searched across PubMed/MEDLINE, Embase, and CENTRAL databases up to May 2024, following data collection. Risk of bias analysis was carried out based on the preferred reporting items for systematic reviews and meta-analyses guidelines and total 16 articles met the inclusion criteria.
The results showed that the apical location and strong adherence to apical structures, such as the optic nerve, were linked to a higher risk of postoperative vision loss. Poor visual prognosis was associated with preoperative visual loss, relative afferent pupillary defect, optic disc abnormalities, and choroidal folds. Intraoperative factors like prolonged vascular handling, optic nerve traction, and low diastolic blood pressure increased risk. Central retinal artery occlusion was identified as the most frequent cause of vision loss.
Investigators concluded the several risk factors existed for poor visual outcomes after excision of OCVMs, emphasizing the need for surgical and anesthetic teams to be aware of these factors and adapt intraoperative management while suggesting further large-scale prospective studies to develop management guidelines.
Source: bjo.bmj.com/content/early/2025/01/29/bjo-2024-326395
