Reversed ocular ischaemic syndrome secondary to carotid cavernous sinus embolisation

Ocular ischaemic syndrome is a progressive and serious vision-threatening condition that is usually associated with carotid artery disease, and poor effective therapeutic options are available. In the present case, a 65-year-old woman was submitted to embolisation of spontaneous carotid-cavernous fistula with complete resolution of initial ophthalmoplaegia and ocular hypertension. Later, ocular ischaemia was detected. Cerebral angiography showed delayed choroidal flush and the patient was admitted for hypervolaemic hypertension therapy and medicated with nimodipine. The ischaemia was reversed and visual function improved.