Posters

Secondary ocular hypertension and outcome of treatment in carotid-cevernous fistula

Poster Details

First Author: D. Wiwatwongwana THAILAND

Co Author(s):    M. Taechajongjintana   K. Unsrisong   A. Wiwatwongwana              

Abstract Details

Purpose:

To determine the occurrence of secondary ocular hypertension (OHT) and its progression to glaucoma in patients with carotid cavernous fistula (CCF) and report treatment outcomes.

Setting:

University-based referral centre in Thailand

Methods:

All patients with newly diagnosed CCF from January 2012 to December 2014 were enrolled. Complete eye examination, fundus photograph, visual field and OCT was performed at baseline to exclude any pre-existing glaucomatous optic nerve damage. Patients were followed at 1week, 1month, 3 months, 6 months, 1 year and annually thereafter. Visual field, OCT and angiography was repeated at 3 months follow up.

Results:

Forty-four patients were included, 21(47.7%) males, with a mean age of 42.5 years. Nineteen patients(43.2%) had direct while 25 (56.8%) had indirect CCF. In the direct CCF group, males were predominant (p = 0.007), mean age was lower (p = 0.000) and initial BCVA was worse (p = 0.022). Secondary OHT (22-53 mmHg) occurred in 14 (31.8%) patients (direct vs. indirect 26.3% vs. 36%) with a higher average intraocular pressure (IOP) in the direct group (mean IOP 31.3 vs. 25.2 mmHg ). At 6 months after treatment, all patients had normalised IOP off all medication and none developed glaucoma.

Conclusions:

Secondary OHT is a common and potentially sight-threatening complication in CCF patients. Awareness, early diagnosis and aggressive treatment can prevent progression to glaucoma.

Financial Disclosure:

NONE