Distensible superficial venous orbital malformations involving the lower eyelid in two horses

Case Description-2 horses were examined because of vascular masses involving the lower eyelid.Clinical Findings-Both horses had a unilateral, fluctuant mass involving the lower eyelid. For horse 1, the mass had been present since birth and had slowly increased in size over time. The mass also changed in size in response to various environmental stimuli, alterations in the position of the horse's head, and digital obstruction of superficial vessels adjacent to the mass. Horse 2 was brought to the hospital for euthanasia, and no historical or antemortem data were available. A combination of contrast angiography, Doppler ultrasonography, surgical exploration, and blood gas analysis (horse 1) and postmortem and histologic examination (horse 2) were used to determine that the masses consisted of non-neoplastic distended venous channels with anastomoses to the inferior lateral palpebral and angularis oculi veins (both horses) as well as the facial vein (horse 2). Histologic examination (horse 2) revealed large, endothelial cell-lined, blood-filled spaces within the deep dermis consistent with a distensible superficial venous orbital malformation.Treatment and Outcome-Horse 1 underwent surgical exploration and ligation of the vascular malformation. Six months after surgery, the mass was markedly reduced in size, and size of the mass was static regardless of head position or environmental stimuli.Clinical Relevance-Thorough preoperative planning with Doppler ultrasonography, contrast angiography, and blood gas analysis is recommended when attempting surgical correction of these malformations in horses. Surgical ligation can result in a successful cosmetic and functional outcome. (J Am Vet Med Assoc 2010;237:943-948)