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Abstract #10037 Published in IGR 5-3
Ocular manifestations and prognosis of secondary glaucoma in patients with carotid-carernous fistula
Ishijima K; Kashiwagi K; Nakano K; Shibuya T; Tsumura T; Tsukahara SJapanese Journal of Ophthalmology 2003; 47: 603-608
PURPOSE: To study the frequency of ocular manifestations and the prognosis of secondary glaucoma in cases of carotid-cavernous fistula (CCF). METHODS: A retrospective multicenter study was conducted to investigate causes, types, ocular symptoms, complications, treatment, and prognosis in subjects with CCF. RESULTS: Of the 43 patients diagnosed with CCF between 1984 and 2000, a total of 13 patients (14 eyes) showed ocular manifestations. CCF was idiopathic in 13 eyes of 12 subjects and resulted from head trauma in one eye of one subject. Of the ocular symptoms and complications, conjunctival hyperemia was the most common, occurring at a rate of 92.9% of the eyes, followed by exophthalmos at 50%, retinal hemorrhage at 50%, retinal venous dilation at 42.9%, vascular bruits at 28.6%, injection of Schlemm's canal at 21.4%, and external ophthalmoplegia at 21.4%. Elevated intraocular pressure (IOP) occurred at a rate of 64.3%, with maximum IOP ranging from 22-55 mmHg. At the final observation, IOP control was favorable in six of the nine eyes showing elevated IOP; five of these nine eyes showed a closed CCF, but none required antiglaucoma treatment, with the exception of one eye in which trabeculectomy was performed. IOP control was unfavorable in the remaining three eyes, and in one of these, CCF was not closed. CONCLUSIONS: Secondary glaucoma is a frequently observed ocular manifestation of CCF, and closure of the fistula is the primary condition required for favorable IOP control.
Dr. K. Kashiwagi, Department of Ophthalmology, University of Yamanashi Faculty of Medicine, 1110 Shimokato, Tamaho, Yamanashi 409-3898, Japan
Classification:
9.4.9 Glaucomas associated with elevated episcleral venous pressure (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
