Abstract

CHICA-CALDERON, Sara; GONZALEZ-ALVIAR, María E.  and  VARGAS-VELEZ, Sergio. Carotid-cavernous fistula, report of a difficult case. Rev. mex. oftalmol [online]. 2021, vol.95, n.5, pp.222-226.  Epub Sep 13, 2021. ISSN 2604-1227.  https://doi.org/10.24875/rmo.m21000157.

We present the case of a 64-year-old female patient with a 7-month history of nonspecific symptoms of diplopia and unilateral proptosis. On physical examination there was a marked limitation of the abduction of the lateral rectus muscle, but magnetic resonance imaging (MRI) showed thickening of the medial rectus. An initial diagnosis of dysthyroid ophthalmopathy was made by a neuroradiologist. Despite treatment, there was no improvement of symptoms so a new evaluation of the MRI was requested, finding signs of a carotid-cavernous fistula. The diagnosis of proptosis is a challenge in ophthalmology. Usually, it is caused by dysthyroid ophthalmopathy; however, other diagnoses should be considered in patients with unusual signs and no improvement with standard treatment.

Keywords : Exophthalmos; Carotid-cavernous sinus fistula; Conjunctivitis.

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