Abstract: Orbital vascular lesions encompass a diverse array of neoplastic and non-neoplastic conditions arising from vascular structures within the orbit. This comprehensive review elucidates the epidemiology, clinical manifestations, diagnostic modalities, management strategies, and recent advancements in the understanding and treatment of orbital vascular tumors. By exploring the intricacies of these lesions, ophthalmologists can enhance their diagnostic acumen and optimize therapeutic interventions for affected patients.

Introduction: Orbital vascular tumors present diagnostic and therapeutic challenges due to their varied clinical presentations and potential for vision-threatening complications. A thorough understanding of their characteristics and management principles is essential for achieving optimal outcomes in affected individuals.

Epidemiology and Classification: Orbital vascular lesions encompass a spectrum of entities, including hemangiomas, lymphangiomas, vascular malformations, and hemangiopericytomas. These lesions may occur at any age and can exhibit diverse clinical behaviors, ranging from asymptomatic incidental findings to rapidly progressive masses causing significant morbidity.

Clinical Features and Diagnosis: Patients with orbital vascular tumors may present with proptosis, eyelid swelling, ptosis, diplopia, or visual disturbances. Diagnosis relies on a combination of clinical examination, imaging studies (MRI, CT, or ultrasound), histopathological evaluation of biopsy specimens, and specialized angiographic techniques. Recent innovations in imaging, such as dynamic contrast-enhanced MRI and optical coherence tomography angiography (OCTA), have enhanced diagnostic accuracy and delineation of vascular architecture.

Management Strategies: Treatment of orbital vascular lesions is tailored to the specific subtype, location, extent, and patient-related factors. Therapeutic modalities may include observation, medical management (e.g., corticosteroids), embolization, surgical resection, and targeted sclerotherapy. Advancements in minimally invasive techniques, including endovascular interventions and image-guided surgery, offer novel approaches to lesion management with reduced morbidity and improved cosmetic outcomes.

Conclusion: Orbital vascular lesions represent a heterogeneous group of pathologies with diverse clinical presentations and management considerations. By staying updated on the latest diagnostic modalities and therapeutic innovations, ophthalmologists can effectively navigate the complexities of these lesions and optimize patient care.

For further reading and reference:

• American Academy of Ophthalmology (AAO) – Orbital Vascular Lesions: https://www.aao.org/bcscsnippetdetail.aspx?id=b55b50a9-7b56-4b13-b37c-264e7e01d74e
• European Society of Ophthalmology (SOE) – Management of Orbital Vascular Tumors: https://soevision.org/management-of-orbital-vascular-tumors/