Recurrent neurosensory macular detachment in carotid-cavernous fistula

Abstract

Case report

A 46 year-old man was seen in the emergency department complaining of vision loss and exophthalmos in his right eye. He also complained of headache, diplopia of 4 months onset, and neurosensory detachment that resolved spontaneously the month before. The study revealed tortuous conjunctival and episcleral vessels and neurosensory macular detachment in his right eye. A carotid-cavernous fistula was confirmed by computed tomography angiography. The fistula closed spontaneously during the hospitalization. One month later, the neurosensory detachment disappeared again.

Discussion

Carotid-cavernous fistula should be included in the differential diagnosis of neurosensory macular detachments. These neurosensory detachments can resolve spontaneously 11 the fistula is closed.

Resumen

Caso clínico

Varón de 46 años, acudió a Urgencias por disminución de agudeza visual y exoftalmos en ojo derecho. Aquejaba cefalea, diplopía de 4 meses de evolución e historia de desprendimiento neurosensorial (DNS) resuelto espontáneamente un mes antes. Presentaba tortuosidad de vasos conjuntivales y epiesclerales y nuevo DNS macular derecho. La sospecha de fístula carótido-cavernosa quedó confirmada mediante angiotomografía computarizada (angio-TC). Durante su ingreso la fístula se cerró espontáneamente. Al mes, el DNS había desaparecido.

Discusión

La fístula carótido-cavernosa debe incluirse en el diagnóstico diferencial de los DNS maculares. El DNS puede desaparecer espontáneamente al cerrarse la fístula.