{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T18:10:03Z","timestamp":1756318203162,"version":"3.44.0"},"reference-count":10,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,1,23]]},"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:p>A man in his mid-70s presented to the eye clinic with sudden onset ptosis, bilateral ophthalmoplegia associated with eye pain and sluggish pupillary reaction. MRI of the head revealed cavernous sinus thrombosis. He was treated with warfarin and a regime of steroids which improved his ophthalmoplegia. Four months following his discharge, he developed a sudden reduction in visual acuity in his right eye; and a dilated fundal examination revealed choroidal effusion. He underwent further diagnostic imaging, and he was diagnosed with right carotid cavernous fistula (CCF). He was managed conservatively with steroids, and his fistula closed spontaneously. He eventually regained his visual acuity. Our case report highlights the challenge in diagnosing CCFs and how choroidal effusion facilitated the diagnosis.<\/jats:p>","DOI":"10.1136\/bcr-2024-264397","type":"journal-article","created":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T12:46:58Z","timestamp":1739278018000},"page":"e264397","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Unilateral choroidal effusion secondary to carotid cavernous fistula"],"prefix":"10.1136","volume":"18","author":[{"given":"James","family":"Ng","sequence":"first","affiliation":[{"name":"Ophthalmology, Frimley Health NHS Foundation Trust, Frimley, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fatimah Zara","family":"Javaid","sequence":"additional","affiliation":[{"name":"Ophthalmology, Frimley Health NHS Foundation Trust, Frimley, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Barker","sequence":"additional","affiliation":[{"name":"Radiology, Frimley Health NHS Foundation Trust, Frimley, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karima","family":"Nesnas","sequence":"additional","affiliation":[{"name":"Ophthalmology, Frimley Health NHS Foundation Trust, Frimley, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,2,11]]},"reference":[{"key":"2025082710321289000_18.2.e264397.1","unstructured":"Kohli GS , Patel BC . Carotid Cavernous Fistula. StatPearls Publishing, 2023."},{"key":"2025082710321289000_18.2.e264397.2","doi-asserted-by":"publisher","DOI":"10.4103\/0974-9233.53862"},{"key":"2025082710321289000_18.2.e264397.3","unstructured":"Reddy AC , Salim S . Choroidal Effusions. EyeNet Magazine, 2012."},{"key":"2025082710321289000_18.2.e264397.4","unstructured":"Meyer M-W . Choroidal effusion: an important hallmark in carotid-cavernous fistula. report on 2 cases. ARVO Annual Meeting Abstract; 2009"},{"key":"2025082710321289000_18.2.e264397.5","doi-asserted-by":"crossref","first-page":"e197","DOI":"10.1097\/WNO.0000000000001443","article-title":"When the Retina Reflects the Brain: An Unusual Presentation of a Carotid-Cavernous Fistula","volume":"43","author":"Touitou","year":"2023","journal-title":"J Neuroophthalmol"},{"key":"2025082710321289000_18.2.e264397.6","first-page":"779","article-title":"CT-revealed choroidal effusions as a sign of carotid cavernous fistula","volume":"21","author":"Kumbhat","year":"2000","journal-title":"AJNR Am J Neuroradiol"},{"key":"2025082710321289000_18.2.e264397.7","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1093\/neuros\/nyw128","article-title":"Spontaneous Bilateral Carotid-Cavernous Fistulas Secondary to Cavernous Sinus Thrombosis","volume":"80","author":"Al-Mufti","year":"2017","journal-title":"Neurosurgery"},{"key":"2025082710321289000_18.2.e264397.8","first-page":"141","article-title":"Carotid-cavernous sinus fistulas and venous thrombosis","volume":"1","author":"Seeger","year":"1980","journal-title":"AJNR Am J Neuroradiol"},{"key":"2025082710321289000_18.2.e264397.9","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1016\/S0039-6257(02)00461-7","article-title":"A red eye and then a really red eye","volume":"48","author":"Bhatti","year":"2003","journal-title":"Surv Ophthalmol"},{"key":"2025082710321289000_18.2.e264397.10","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2415-12-28","article-title":"Worsening angle closure glaucoma and choroidal detachments subsequent to closure of a carotid cavernous fistula","volume":"12","author":"Thinda","year":"2012","journal-title":"BMC Ophthalmol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-264397","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T17:32:18Z","timestamp":1756315938000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-264397"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2]]},"references-count":10,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,2,11]]},"published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1136\/bcr-2024-264397"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-264397","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,2]]}}}