A continuous red eye: Case report about a carotid cavernous fistula

The purpose of the study is to present a case of indirect carotid cavernous fistula (CCF) successfully treated with endovascular approach. A 46-year-old male presented with a progressive, painless visual loss and conjunctival injection of the right eye with 1 month of evolution. On ophthalmology exa...

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Bibliographic Details
Main Authors: Sonia Cristina Raposo Parreira, Sandra Barros, Diogo Lopes, Joaquim Silva, Nuno Campos
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2019-01-01
Series:The Pan-American Journal of Ophthalmology
Subjects:
Online Access:http://www.thepajo.org/article.asp?issn=2666-4909;year=2019;volume=1;issue=1;spage=11;epage=11;aulast=Parreira
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Summary:The purpose of the study is to present a case of indirect carotid cavernous fistula (CCF) successfully treated with endovascular approach. A 46-year-old male presented with a progressive, painless visual loss and conjunctival injection of the right eye with 1 month of evolution. On ophthalmology examination, the patient had best-corrected visual acuity of 20/30 in the right eye and an intraocular pressure (IOP) of 20 mmHg. The patient still had pulsating proptosis and an orbital bruit on the auscultation. Slit-lamp examination revealed corkscrew episcleral vessels. The patient was submitted a magnetic resonance angiography that confirmed the presence of an indirect carotid-cavernous sinus fistula. The patient was submitted to endovascular embolization by the transarterial approach to close the fistula with complete clinical and imaging resolution. Two months after the procedure, the visual acuity was 20/20, and the IOP was 8 mmHg. CCF is an uncommon disease and may be misdiagnosed when there are few signs and symptoms on presentation. Different subtypes of CCF cause different clinical signs, with varying speeds of onset and severity. The diagnosis is based on clinical findings and by imaging studies. However, the definite diagnosis is only possible with cerebral angiography. It is important to consider risks and benefits in relation to endovascular treatment, mainly in indirect CCF.
ISSN:2666-4909
2666-4909