J Korean Ophthalmol Soc.  2022 Dec;63(12):1023-1027. 10.3341/jkos.2022.63.12.1023.

Carotid Cavernous Fistula with Central Retinal Vein Occlusion

Affiliations
  • 1Department of Ophthalmology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
  • 2Department of Neurosurgery, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
  • 3BnC Ophthalmic Clinic, Goyang, Korea

Abstract

Purpose
To report a rare case of slow progression of carotid cavernous fistula (CCF) with central retinal vein occlusion (CRVO).
Case summary
A 66-year-old man presented with conjunctival injection and proptosis in the right eye. Best-corrected visual acuity was 0.8 and 0.5 in the right and left eye, respectively, and conjunctival vessel enlargement and subconjunctival hemorrhage were observed in the right eye on slit lamp examination. Due to suspicion of CCF, computed tomography, computed tomography angiography, magnetic resonance imaging, and magnetic resonance angiography were performed. These analyses showed no vascular abnormalities associated with arteriovenous shunt, so the patient was followed up closely. About 1 month later, his conjunctival vessel engorgement became severe and CRVO derived from venous stasis by CCF occurred, so transfemoral cerebral angiography was performed and a diagnosis of CCF was made. Intravitreal anti-vascular endothelial growth factor injection was performed for CRVO, and best corrected visual acuity improved to 1.0 in the right eye.
Conclusions
Slowly progressing CCF can be accompanied with rare intraocular disease, such as CRVO, so appropriate diagnosis through detailed evaluation is important for treatment.

Keyword

Carotid cavernous fistula; Retinal vein occlusion
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