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Neovascular glaucoma with combined retinal vascular occlusion in carotid cavernous fistula
  1. Shreyas Temkar,
  2. Jagadeeshwari Jayaseelan,
  3. Amit Kumar Deb and
  4. Subashini Kaliaperumal
  1. Ophthalmology, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India
  1. Correspondence to Dr Subashini Kaliaperumal; subadoc{at}


Carotid cavernous fistulas (CCFs) can present with varied ophthalmic manifestations. The most important vision-threatening complications of CCF include glaucoma and retinal vascular occlusions. We report a case of a man in his early 30s who developed a post-traumatic direct CCF. The patient denied undergoing embolisation therapy. This resulted in aggravation of his condition with onset of combined retinal venous and artery occlusion leading to neovascular glaucoma and severe vision loss. He was treated with medical management followed by diode laser photocoagulation to control intraocular pressure. Diagnostic cerebral angiography done 3 months later showed complete closure of the fistula; hence, no further intervention was advocated. Combined vascular occlusion is a rare vision-threatening occurrence in cases of CCF. Timely intervention with closure of the fistula can prevent the development of vision-threatening complications.

  • Glaucoma
  • Retina
  • Trauma CNS /PNS
  • Neuroimaging
  • Interventional radiology

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  • Contributors ST, JJ, AKD and SK examined the patient. ST and SK treated the patient. All authors were involved in writing the manuscript and approved it for publication.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.