Choroidal Folds and Dural Cavernous Sinus Fistula

Abstract

Dural cavernous sinus fistulas may undergo spontaneous resolution with transient worsening of clinical signs and symptoms. We report such a case and document the first association of choroidal folds with this vascular malformation. Report of a Case. —A 66-year-old woman was evaluated for sudden worsening of right eye redness that had been present for 6 weeks. Visual acuity was 20/30 OD and 20/25 OS. Pupils were normal. Examination of the right eye showed 5-mm proptosis, limited supraduction and infraduction, upper and lower eyelid edema, chemosis, and dilated episcleral vessels. Results of left eye examination were normal. Intraocular pressures were 36 mm Hg OD and 16 mm Hg OS. Spontaneous venous pulsations were absent on the right, but present on the left. The fundi were otherwise normal. Computed tomography demonstrated a prominent right superior ophthalmic vein and enlargement of the right extraocular muscles. A presumptive diagnosis of dural cavernous sinus fistula