Acute closed-angle glaucoma after arteriovenous fistulas.
Unilateral secondary acute closed-angle glaucoma was associated with a ciliochoroidal detachment in two patients. One patient, aged 17 years, had an orbital arteriovenous fistula. The other patient, aged 73 years, had a dural arteriovenous fistula that originated from branches of the right internal maxillary artery. In each patient there was increased intraocular pressure, a moderately shallow central anterior chamber, and a flat peripheral anterior chamber. The ciliochoroidal detachment was postulated to displace the iris-lens diaphragm, resulting in the closed angle. Closure of the orbital fistula in the 17-year-old patient reduced the ciliochoroidal detachment and relieved the glaucoma, but visual acuity was reduced to 20/200. The glaucoma in the 73-year-old patient was relieved with topical instillation of timolol 0.5%, homatropine 5%, and systemic administration of acetazolamide. The fistula closed spontaneously, with relief of other ocular signs of the arteriovenous fistula.
Fourman
S
S
Department of Opthalmology, University of Pittsburgh, Pennsylvania 15213.
D000208:Acute Disease; D000293:Adolescent; D000368:Aged; D000867:Anterior Chamber / Q000473:pathology; D001164:Arteriovenous Fistula / Q000150:complications* / Q000601:surgery; D002829:Choroid; D002924:Ciliary Body; D004388:Dura Mater / Q000098:blood supply; D005260:Female; D005901:Glaucoma / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D006801:Humans; D009915:Orbit / Q000098:blood supply; D014603:Uveal Diseases / Q000150:complications; D014792:Visual Acuity