Proliferative retinopathy after treatment of carotid-cavernous fistulas

The carotid-cavernous fistulas of two young patients were treated by multiple carotid artery ligations. The fistulas persisted, supplied by retrograde flow through the ophthalmic artery. In one patient, neovascularization of the optic disc occurred and, in spite of suspected later spontaneous closure of the fistula, progressed to cause nearly total loss of vision. Spontaneous closure of the fistula also occurred in the other patient, but vitreous hemorrhage due to neovascularization of the retina developed four years later.