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March 1986

Central Retinal Vein Occlusion Complicating Spontaneous Carotid-Cavernous Fistula

Arch Ophthalmol. 1986;104(3):331. doi:10.1001/archopht.1986.01050150025003

To the Editor.  —Several authors have emphasized the relatively benign clinical course of spontaneous carotidcavernous fistulas compared with that of traumatic fistulas. We herein report the occurrence of a central retinal vein occlusion in a patient who was being followed up for a spontaneous carotid-cavernous fistula.

Report of a Case.  —A 68-year-old obese but otherwise healthy woman developed redness of her right eye and diplopia in April 1984. One month later, she was found to have a visual acuity of 20/30 OD and 20/25 OS. The right eye showed 6 mm of proptosis and dilated tortuous conjunctival vessels. Paresis of the right sixth nerve was present, with an esotropia of 30 diopters, and there was limitation of abduction to just beyond the midline. Intraocular pressures were 28 mm Hg OD and 18 mm Hg OS. The fundi were normal. Orbital auscultation revealed a bruit. A diagnosis of spontaneous carotid-cavernous fistula

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