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Type presentatieE-poster
TitelIntraocular hypertension caused by elevated episcleral venous pressure following arteriovenous fistula embolization
DoelTo report an interesting case of an ethmoidal arteriovenous fistula embolization and subsequent elevated episcleral venous pressure leading to intraocular hypertension
MethodesA 45 years-old male patient with a history of two rhinoplasty surgeries developed years after the second procedure symptoms of headache, facial oedema and frontal venous congestion.
Angiography revealed an ethmoidal AVF primarily supplied by the left ophthalmic artery and left sphenopalatine artery. Venous drainage occurred through the left superior ophthalmic vein and temporal veins.
Due to the complexity of the lesion, a two-stage transarterial embolization procedure was performed
The first embolization procedure was done through the left ophthalmic artery, disconnecting the branches feeding the lesion
The second intervention took place two months later, embolizing feeding vessels emanating from the right ophthalmic artery and right facial artery
ResultatenThe patient developed days after the second procedure signs of progressive proptosis, conjunctival injection and chemosis of the left eye
The ophthalmic examination revealed an intraocular pressure (IOP) of 25 mmHg in the left eye (vs 15 mmHg in the right eye), blood reflux in Schlemm’s canal and veinous stasis in the fundus of the left eye
The angiography demonstrated a severe circulatory slowdown in the left superior ophthalmic vein
ConclusieWe suspect a migration of the embolic material to the left superior ophthalmic vein responsible for the blood flow alteration and the elevation of the EVP
Our patient will necessitate regular ophthalmic evaluation as he is at increased risk of secondary open-angle glaucoma, acute angle-closure glaucoma, uveal effusion, central retinal vein and artery occlusion
BelangenverstrengelingNee
Auteur 1
NaamKHALATYAN
InitialenG
InstituutOphthalmology department, Saint-Luc, Delta, Brussels
Auteur 2
NaamPourjavan
InitialenS
InstituutOphthalmology department, Saint-Luc, Delta, Brussels
Auteur 3
NaamOtjacques
InitialenL
InstituutOphthalmology department, Chirec Hospital, Delta, Brussels
Auteur 4
NaamMarinescu
InitialenC
InstituutOphthalmology department, Chirec Hospital, Delta, Brussels
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