ABSTRACT

No matter what the etiologic cause for CCF is, its serious complications can be prevented and visual rehabilitation can be obtained with early diagnosis and treatment.

A 44 year old female patient was admitted to Dr.Lutfi Kırdar Kartal Training and Research Hospital's 1 st Ophthalmology Clinic complaining of progressively increasing pain, redness and enlargement of the eye. On initial ophthalmic examination, corrected visual acuity was 0.3 in the right and 1.0 in the left eye. Biomicroscopic exa.mina.tion revealed the right eyelid edema, conjunctival hiperemia and chemosis, proptosis, fixed dilated pupil, (-) light reflex in the right eye while the left eye was normal. Fundus examination of the right eye showed obvious venous dilatation and increased tortuosity, arterial narrowing and flame shaped preretinal hae-morrhages and the left eye was normal. Intraocular pressure with applanation tonometer was measured as 34 mmHg in the right and 16 mmHg in the left eye. Following the detailed eye examination, orbital color doppler imaging, contrasted and non-contrasted computerized axial orbital tomography, cranial magnetic resonance imaging, magnetic resonance angiography and digital substract angiography (DSA) were applied to the patient. As a result of these radiologi-cal tests, the patient was diagnosed as carotid-cavernous fistula (CCF). After that, cavernous si-nus was occluded by placing silicone balloon. After a week, an obvious improvement was noti-ced in the eye exam.