Not the usual suspect

Andrew G Lee; Jonathan D Shader; Aroucha Vickers; Orlando M Diaz; Jurij R Bilyk

doi:10.1016/j.survophthal.2017.10.001

Not the usual suspect

Surv Ophthalmol. 2019 Mar-Apr;64(2):248-253. doi: 10.1016/j.survophthal.2017.10.001. Epub 2017 Oct 9.

Authors

Andrew G Lee¹, Jonathan D Shader², Aroucha Vickers³, Orlando M Diaz⁴, Jurij R Bilyk⁵

Affiliations

¹ Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas, USA; Weill Cornell Medicine, Department of Ophthalmology, New York, New York, USA; Weill Cornell Medicine, Department of Neurology, New York, New York, USA; Weill Cornell Medicine, Department of Neurosurgery, New York, New York, USA. Electronic address: aglee@houstonmethodist.org.
² Western University of Health Sciences, College of Osteopathic Medicine of the Pacific Northwest, Lebanon, Oregon, USA.
³ Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas, USA.
⁴ Department of Radiology and Neurosurgery, Weill Cornell Medicine, Houston Methodist Hospital, Houston, Texas, USA.
⁵ Skull Base Division, Neuro-Ophthalmology Service, Wills Eye Hospital, Philadelphia, Pennsylvania, USA.

PMID: 29024673
DOI: 10.1016/j.survophthal.2017.10.001

Abstract

An 82-year-old woman presented with right-sided proptosis, chemosis, and a supraorbital bruit. A dural carotid-cavernous fistula was suspected, but catheter angiography revealed an intraorbital inferior ophthalmic vein arteriovenous fistula supplied by the right ophthalmic artery and infraorbital branch of the internal maxillary artery. A primary orbital arteriovenous fistula can mimic the clinical and radiographic features of the more common carotid-cavernous fistula.

Keywords: asymmetrically elevated intraocular pressure; carotid cavernous fistula; orbital arteriovenous fistula; orbital mass with heterogenous enhancement.

Publication types

Case Reports

MeSH terms

Accidents, Traffic
Aged, 80 and over
Arteriovenous Fistula / diagnostic imaging*
Arteriovenous Fistula / therapy
Brain Injuries / etiology
Carotid-Cavernous Sinus Fistula / diagnosis*
Cerebral Angiography
Diagnosis, Differential
Diplopia / diagnosis
Embolization, Therapeutic / methods
Eye Pain / diagnosis
Female
Humans
Maxillary Artery / abnormalities*
Maxillary Artery / diagnostic imaging
Ophthalmic Artery / abnormalities*
Ophthalmic Artery / diagnostic imaging
Orbital Diseases / diagnostic imaging*
Orbital Diseases / therapy
Tomography, X-Ray Computed
Veins / abnormalities*
Veins / diagnostic imaging
Vision Disorders / diagnosis