Pigment Epithelium Detachment Following Carotid Cavernous Sinus Fistula

Background

Indirect or dural carotid cavernous fistulas (CCFs) do not occur often, develop spontaneously, and initially manifest with mild and non-specific signs. Therefore, these lesions are often misdiagnosed. Dural CCFs represent a communication between the cavernous sinus and one or more meningeal branches of the internal carotid artery, external carotid artery, or both. As in our case, dural CCFs typically occur in middle-aged or elderly women. In the mildest cases, signs include redness of the eye caused by dilatation and arterialization of both conjunctival and episcleral veins, chemosis, and eyelid swelling. In addition, patients may show proptosis, diplopia and elevated intraocular pressure (IOP) [3]. Retinal abnormalities, although rare, include venous stasis retinopathy, central retinal vein occlusion, serous retinal detachment, choroidal folds, choroidal effusion, choroidal detachment, and optic disc swelling [1] [2] [4] [6] [7].

References

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