Anterior segment OCT, Schlemm's canal, and carotid-cavernous fistula: Reflections on a clinical case.

Arch Soc Esp Oftalmol (Engl Ed)Jun 10, 2026 (epub)
Case ReportOphthalmologyRadiology (Diagnostic)

J González Martín-Moro, V Altares Mateos

✦ AI-curated · Sources linked

Case in brief

A 69-year-old man presented with diplopia and right-eye conjunctival injection with corkscrew vessels, proptosis, and sixth cranial nerve palsy. He was diagnosed with a right carotid-cavernous fistula. Despite normal intraocular pressure, gonioscopy showed a pinkish trabecular meshwork, while anterior segment OCT did not identify Schlemm’s canal. The report discusses the potential usefulness and limitations of OCT for assessing the canal in this setting.

What made this case unusual

Schlemm’s canal was not identifiable on anterior segment OCT despite normal intraocular pressure; gonioscopy showed a pinkish trabecular meshwork.

Diagnostic / clinical pearl

In carotid-cavernous fistula, a pinkish trabecular meshwork may be seen even when intraocular pressure is normal, and anterior segment OCT may not identify Schlemm’s canal.

Source

PubMed · PMID 42269965

Published in Arch Soc Esp Oftalmol (Engl Ed). This summary was written by xxcode from the publication's abstract and metadata. It is not peer reviewed and is not a substitute for the original article. For clinical decisions, review the original publication.

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