May 2008
Volume 49, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2008
Ophthalmological Symptoms in Carotid-Cavernous Sinus Fistulas
Author Affiliations & Notes
  • L. Boivin
    Dupuytren Hospital, Limoges, France
    Ophthalmology, Dupuytren Hospital,
  • R. Chapot
    Dupuytren Hospital, Limoges, France
    Radiology,
  • J.-P. Adenis
    Dupuytren Hospital, Limoges, France
    Ophthalmology, Dupuytren Hospital,
  • E. Houdart
    Neuro-radiology, Lariboisière Hospital, Paris, France
  • P.-Y. Robert
    Dupuytren Hospital, Limoges, France
    Ophthalmology, Dupuytren Hospital,
  • Footnotes
    Commercial Relationships  L. Boivin, None; R. Chapot, None; J. Adenis, None; E. Houdart, None; P. Robert, None.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science May 2008, Vol.49, 6021. doi:https://doi.org/
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      L. Boivin, R. Chapot, J.-P. Adenis, E. Houdart, P.-Y. Robert; Ophthalmological Symptoms in Carotid-Cavernous Sinus Fistulas. Invest. Ophthalmol. Vis. Sci. 2008;49(13):6021. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : This study was designed to compare ophthalmological symptoms of dural fistulas (DF) and carotid-cavernous direct fistulas (CCF), before and after endovascular treatment, and to find out risk factors for ophthalmological sequellae.

Methods: : We retrospectively studied 44 patients suffering from cavernous sinus fistulas with ophthalmologic symptoms, held in Lariboisière Hospital in Paris and Dupuytren Hospital in Limoges over 8 years. Twenty-four patients had DF, 20 had CCF. Two patients had spontaneous disappearance of the fistula, and 4 after non-invasive treatment. The remaining 40 patients underwent endovascular treatment, until complete exclusion of the fistula (33 had a single treatment, and 5 had to be retreated).

Results: : The main pre-treatment symptoms were proptosis (n=38), episcleral venous congestion (n=31), oculomotor palsy (n=28), visual loss (n=20), glaucoma (n=17) and controlateral ocular symptoms (n=11). Thrill and murmur were more frequent in CCF (6 and 12) than in DF (0 and 5) (p<0,05). In patients with DF, the average age was greater (p<0,005) and glaucoma more frequent (p=0,005). Fourteen patients had ophthalmological sequellae, oculomotor palsies in most cases (n=8). Ophthalmological sequellae were more frequent in patients with pre-treatment visual impairement (p<0,05).

Conclusions: : The risk of ophthalmological sequellae was higher in patients with pre-treatment visual impairement, and lower in patients with complete anatomical cure of the fistula. 68% of patients had no ophthalmological sequellae after endovascular treatment, and 93,2% after specific additional medical treatment.

Keywords: clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials • neuro-ophthalmology: diagnosis • quality of life 
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