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A dural cavernous sinus fistula can cause a number of different ocular findings. We report a case of dural cavernous sinus fistula causing an isolated macular exudative detachment.
An 84-year-old woman was initially seen because of a 1-month history of diplopia and left periorbital pain. She had well-controlled hypertension and a history of a rhegmatogenous retinal detachment in the right eye, which was repaired 10 years previously. There was no history of trauma.
Her visual acuity was 20/60 OD and 20/25 OS. Hertel exophthalmometry was 15 mm on the right and 18 mm on the left. Supraorbital bruits were present bilaterally. Episcleral vessels were tortuous in the left eye. The right fundus had dry macular pigmentary changes. The left fundus was normal. Orbital Doppler imaging revealed arterialization of blood flow in both superior ophthalmic veins; the arterial pulse wave was consistent with bilateral, low-flow dural cavernous sinus fistulas.
Garg SJ, Regillo CD, Aggarwal S, Bilyk JR, Savino PJ. Macular Exudative Retinal Detachment in a Patient With a Dural Cavernous Sinus Fistula. Arch Ophthalmol. 2006;124(8):1201–1202. doi:10.1001/archopht.124.8.1201
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