Purpose: Dural arteriovenous fistula (dAVF) is often complicated by central retinal vein occlusion (CRVO) or serous retinal detachment (SRD) as a result of venous stasis. Here we report on the successful observation of choroidal blood flow over time with laser speckle flowgraphy (LSFG) in a case of dAVF accompanied by SRD that spontaneously resolved within a short period.
Case presentation: A 90-year-old woman presented to Toho University Sakura Medical Center because of decreased visual acuity in the left eye. Anterior ocular findings at the initial examination were hyperemia and exophthalmos of the left eye. Optical coherence tomography (OCT) revealed SRD accompanying choroidal circulation congestion and non-ischemic CRVO. Head magnetic resonance imaging revealed marked expansion of the left superior ophthalmic vein. On the basis of these findings and cerebral angiography findings, the patient was diagnosed with dAVF of the cavernous sinus. Mean blur rate (MBR), which refers to relative blood flow speed, was 6.2 in the macular region of her left eye. This was markedly lower than that in the right eye (MBR: 17.7). At 8 weeks after the initial examination, MBR in the left eye had increased to 11.2, with improvements also seen in the SRD and clinical findings.
Conclusions: Impaired choroidal blood flow may be involved in the pathogenesis of SRD associated with dAVF. It is considered that LSFG is useful for noninvasive and quantitative evaluation of the pathogenesis and clinical course in patients with dAVF.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 122: 868-874, 2018.