CAVERNOUS-DURAL FISTULA WITH SECONDARY ANGLE-CLOSURE GLAUCOMA

PURPOSE: To report a rare case of angle closure glaucoma, secondary to the rapid development of a choroidal effusion, in a patient with a lo ng-standing cavernous-dural shunt. METHODS: Case report. Investigation s included computed tomographic scan, magnetic resonance imaging, and carotid angiography. RESULTS: The development of the choroidal effusio n occurred because of partial thrombosis of the ipsilateral superior o phthalmic vein and cavernous sinus. Drainage of the choroidal effusion resolved the angle closure glaucoma. CONCLUSIONS: The combination of worsening signs and evidence of thrombosis indicates impending resolut ion of a cavernous-dural shunt. However, if a choroidal effusion cause s angle-closure glaucoma, prompt surgical drainage should be considere d to prevent permanent peripheral anterior synechiae formation, with t he expectation that the effusion will not recur.