PMC7060914_01
Facial photography demonstrating; (A) left axil proptosis; (B) dilated episcleral vessels with corkscrew-like aspect on the left eye
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A), and dilated episcleral vessels (corkscrew-like aspect) (Figure 1 B). Anterior segment examination was unremarkable.
(A) left eye fundus photography revealing venous engorgement and tortuosity; (B) carotid arteriography showing direct CCF with opacification of the inferior petrosal sinus; the superior ophthalmic vein is thrombosed and slightly opacified
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Fundoscopic examination found venous engorgement and tortuosity with normal optic disc aspect (Figure 2 A). As expected this test revealed the presence of left CCF with shunt onthe C3-C4 segment of the internal carotid artery (ICA).The venous drainage was via posterior into the inferior petrosal sinus, lateral into the sphenoparietal sinus and the superior sagittal sinus, inside into the contralateral cavernous sinus and anterior the thrombosed superior ophthalmic vein was slightly opacified (Figure 2 B).
Left eye photography (A) and fundus photography (B) regression of the conjunctival vessels dilatation as well as retinal venous engorgement and tortuosity after fistula embolization
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After 20 days we have noticed regression of exophthalmos, conjunctival vessels vasodilatation as well as retinal venous engorgement and tortuosity (Figure 3 A,B).