CAROTID CAVERNOUS SINUS FISTULA FINDINGS IN OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY BEFORE AND AFTER PERCUTANEOUS EMBOLIZATION

• Published in: Retinal cases & brief reports Vol. 17; no. 4; p. 478
• Main Authors: Del Mar Schilt-Catafal, Maria, Pastor-Escartín, Félix, Martínez-Piñero, Ana, Neira-Ibáñez, Paulina, Manfreda-Domínguez, Laura, Duch-Samper, Antonio M
• Format: Journal Article
• Language: English
• Published: United States 01.07.2023
• Subjects: Angiography; Carotid-Cavernous Sinus Fistula - diagnosis; Carotid-Cavernous Sinus Fistula - etiology; Carotid-Cavernous Sinus Fistula - therapy; Embolization, Therapeutic - adverse effects; Fistula; Humans; Tomography, Optical Coherence
• ISSN: 1937-1578
• DOI: 10.1097/ICB.0000000000001224

Optical coherence tomography angiography has been used to evaluate the posterior segment in a wide variety of pathologies because it is a noninvasive image technique, but its role in the evaluation of the retina in a case of carotid cavernous sinus fistula has not been described yet. We present a patient who consulted with spontaneous left superior eyelid hematoma and was diagnosed with left indirect carotid cavernous sinus fistula. In this study, optical coherence tomography angiography was used to evaluate the different macular capillary plexuses in a patient with carotid cavernous sinus fistula and a clinical situation of secondary local venous stasis before and after percutaneous embolization. Augmented vessel density was seen in superficial and deep capillary plexuses and in choriocapillaris before the percutaneous embolization, and a decrease of the parameters was seen after the treatment. All macular capillary plexuses presented with augmented vessel density levels that normalized after treatment. These findings were previously undescribed, and they suggest that optical coherence tomography angiography may be useful to initially evaluate patients with carotid cavernous sinus fistula who are planned to undergo embolization and to follow them up until normalization of the vascular structures is reported.