Jain Mukesh, Alam Md Shahid, Mukherjee Bipasha, Raman Rajiv
Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, India.
Department of Orbit Oculoplasty Reconstructive and aesthetic services, Sankara Nethralaya, Chennai, India.
GMS Ophthalmol Cases. 2017 Aug 25;7:Doc20. doi: 10.3205/oc000071. eCollection 2017.
Carotid cavernous fistulae (CCFs) are abnormal communications between the cavernous sinus and the carotid arterial system. Based on the etiology, CCFs can be traumatic, spontaneous and rarely iatrogenic. We report an interesting case of new onset CCF associated with shallow choroidal detachment after trabeculectomy surgery. Observational case report A 69-year-old male patient presented with complain of proptosis, congestion, and gross diminution of vision in the left eye following trabeculectomy elsewhere. Delayed suprachoroidal hemorrhage was diagnosed by the primary physician and the patient was on oral steroids. On USG-B scan, choroidal detachment and a dilated superior ophthalmic vein were seen. A digital subtraction angiogram showed type D CCF. In view of nil visual prognosis, he was treated conservatively and was referred to a neuroradiologist for further management. CCFs have been rarely reported after intraocular surgeries. Till date, there is one case report of CCF complicating cataract surgery. Interestingly, CCFs has not been reported complicating trabeculectomy surgery. Dural CCFs although uncommon should be considered a close differential of hemorrhagic choroidal detachment, a relatively common complication following intraocular surgery.
颈动脉海绵窦瘘（CCF）是海绵窦与颈动脉系统之间的异常交通。根据病因，CCF可分为外伤性、自发性，医源性者罕见。我们报告了1例小梁切除术后出现与脉络膜脱离相关的新发CCF的有趣病例。观察性病例报告 一名69岁男性患者因在其他地方行小梁切除术后出现左眼眼球突出、充血和视力严重下降而就诊。首诊医生诊断为迟发性脉络膜上腔出血，患者正在口服类固醇药物。在超声B超检查中，可见脉络膜脱离和眼上静脉扩张。数字减影血管造影显示为D型CCF。鉴于视力预后不佳，对其进行了保守治疗，并转诊给神经放射科医生进行进一步处理。 眼内手术后很少有CCF的报道。迄今为止，有1例CCF并发白内障手术的病例报告。有趣的是，尚未有小梁切除术后并发CCF的报道。硬脑膜CCF虽然不常见，但应被视为出血性脉络膜脱离的相近鉴别诊断，后者是眼内手术后相对常见的并发症。
