SEROUS CHOROIDAL DETACHMENT ASSOCIATED WITH SUSPECTED CONTRALATERAL CAVERNOUS SINUS THROMBOSIS.

Area of Science:

• Ophthalmology
• Neurology
• Vascular Imaging

Background:

• Cavernous sinus thrombosis (CST) is a rare but serious condition involving blood clot formation in the cavernous sinus.
• Ocular manifestations of CST can be diverse, including vision loss and extraocular muscle dysfunction.
• Choroidal detachment (CD) is typically associated with hypotony or inflammation, but its association with CST is less common.

Purpose of the Study:

• To report a case of choroidal detachment (CD) occurring secondary to cavernous sinus thrombosis (CST).
• To highlight the importance of considering CD in patients presenting with ocular symptoms and suspected CST.

Main Methods:

• A case report detailing the clinical presentation, diagnostic workup, and management of a patient with CST and CD.
• Utilized computed tomography venography, diagnostic angiography, dilated fundus examination, and magnetic resonance imaging (MRI) for diagnosis.

Main Results:

• A 73-year-old male with a history of glaucoma and pseudophakia presented with right eye pain, blurred vision, and diplopia.
• Initial imaging suggested carotid-cavernous fistula (CCF), but subsequent angiography ruled this out and indicated CST.
• Fundus examination and MRI revealed multiple serous choroidal detachments in the right eye, which resolved with systemic CST treatment and topical steroids.

Conclusions:

• Choroidal detachment should be recognized as a potential complication during the course of cavernous sinus thrombosis.
• Impaired venous drainage in CST can lead to fluid transudation into perivascular spaces, resulting in choroidal effusion and detachment.