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Abstract #19274 Published in IGR 9-3
Massive exophthalmos after traumatic carotid-cavernous fistula embolization
Mateos E; Arruabarrena C; Veiga C; Ruiz-Zarate B; Valdes JJ; Rojo POrbit 2007; 26: 121-124
An 18-year-old man without previous clinical problems developed a left traumatic carotid-cavernous fistula after a traffic accident. An endovascular embolization with coils was performed without success. The drainage was derived to the superior ophthalmic vein solely and clinical worsening occurred. Left eye proptosis, chemosis and intraocular pressure increased. Complete ophthalmoplegia developed and visual acuity decreased due to a central retinal vein obstruction. After a second embolization attempt the fistula was closed successfully but proptosis, chemosis and intraocular pressure remained uncontrolled despite medical treatment. Therefore an orbital decompression surgery was performed. Ophthalmoplegia, proptosis and chemosis improved and intraocular pressure was controlled. Although retinal hemorrhages persist, no neovascularization has developed. Central retinal vein occlusion in young patients seems to have a different etiology than in the elderly. In young patients, local factors are more frequently identified than systemic vascular diseases.1 Early detection of central retinal vein obstruction may prevent deterioration of visual acuity.
Dr. C. Arruabarrena, C/ Pintor Goya N1 3 B, 28100 Alcobendas, Madrid, Spain. carruabarrena@eresmas.com
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)