Ophthalmic findings in dural arteriovenous shunts

Five cases of dural carotid arteriovenous shunts in the region of the cavernous sinus are reported. Discussion of the specific carotid angiographic features stresses the pathophysiologic characteristics of these shunts in relation to the ophthalmic findings. In all cases, the meningohypophyseal artery was involved as the sole or predominant source of the afferent arterial supply, and the degree of proptosis, epibulbar congestion and secondary glaucoma correlated with retrograde filling of the superior ophthalmic vein from the cavernous sinus. The ophthalmologist's early recognition of this entity as a "spontaneous" pathologic occurrence is important, since he is intimately involved in its diagnosis and long-term management.