Abnormal chloroidal circulation: association with arteriovenous fistula in the cavernous sinus area
R. Klein, S. M. Meyers, J. L. Smith, F. L. Myers, H. Roth and B. Becker
Abnormalities in the choroidal circulation developed in two patients with
arteriovenous fistulae in the area of the cavernous sinus. Fluorescein
angiography in both patients revealed delayed filling of their choroidal
circulation. In the first patient, this was associated with a central
serous detachment of the retina secondary to a retinal pigment epithelial
defect. In the second patient, a large choroidal detachment and serous
retinal detachment, which resolved spontaneously developed. High venous
pressure, low mean arterial pressure, and subsequent tissue hypoxia are
postulated to be the cause of the altered choroidal circulation. The
possibility of occult dural arteriovenous fistulae should be considered in
the differential diagnosis in patients with a choroidal detachment,
proptosis, and a red eye.
