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Presentation type	E-poster
Title	Intraocular hypertension caused by elevated episcleral venous pressure following arteriovenous fistula embolization

Purpose	To report an interesting case of an ethmoidal arteriovenous fistula embolization and subsequent elevated episcleral venous pressure leading to intraocular hypertension
Methods	A 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
Results	The 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
Conclusion	We 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
Conflict of interest	No

Authors 1

Last name	KHALATYAN
Initials	G
Department	Ophthalmology department, Saint-Luc, Delta, Brussels

Authors 2

Last name	Pourjavan
Initials	S
Department	Ophthalmology department, Saint-Luc, Delta, Brussels

Authors 3

Last name	Otjacques
Initials	L
Department	Ophthalmology department, Chirec Hospital, Delta, Brussels

Authors 4

Last name	Marinescu
Initials	C
Department	Ophthalmology department, Chirec Hospital, Delta, Brussels