Visual prognosis in carotid-cavernous fistula.

The initial signs and symptoms and subsequent course of 74 patients with carotid-cavernous fistula were evaluated in relation to the prognosis for final visual acuity. Two thirds of the patients underwent carotid artery surgery because of the fistula. Of this surgical group, 12 (28%) had further visual loss and 5 (10%) had cerebral ischemia. Elevated intraocular pressure tended to be more frequent in patients with proptosis and conjunctival injection, but elevated pressure did not seems to be a major cause of visual loss. The visual prognosis was more favorable in this series than in previous reports.