To explore the ocular manifestations, imaging examination and interventional treatment of carotid cavernous fistula.

Retrospective analysis of the ocular symptoms and signs, imaging examinations, and treatment methods of 18 cases of carotid cavernous fistula who were first diagnosed in our hospital in 5 years was performed. All 18 patients underwent interventional treatment. Among them, 12 cases were sealed with detachable balloons, 3 cases were sealed with coils and Onyx, and 3 cases were covered with stent graft.

The most common ocular manifestations in all cases were pulsatile eyeball protrusion, conjunctival congestion and edema, and eye movement disorders. All CT scans of the head or eyes showed that the eyeballs were protruded and the superior ocular veins were enlarged; all patients underwent digital subtraction angiography to confirm the diagnosis. All 18 cases (20 eyes) in this group underwent interventional treatment. Among them, 12 cases (14 eyes) were sealed with a detachable balloons to seal the fistula. As a result, 10 cases (12 eyes) were completely occluded, and 2 cases had complications, There were no serious complications or deaths. 3 cases(3 eyes) of fistula were sealed with coils & Onyx , and 3 cases (3 eyes) were isolated with stent graft. The fistula was completely occluded without complications or deaths. The ocular symptoms and signs of all patients were significantly improved. During the follow-up period (12±3.4 months), there was no recurrence, and no stenosis and occlusion occurred in the carotid stent graft.

For patients with exophthalmos and other related symptoms in ophthalmology, the possibility of carotid cavernous fistula should be considered. Angiography is the gold standard for the diagnosis of the disease. Interventional treatment is safe and effective for carotid cavernous fistula