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Ophthalmology
Utility of laser speckle flowgraphy in screening for carotid-cavernous fistula
  1. Takahiro Mizukami1,
  2. Satoru Ueno2,
  3. Soichiro Mishima1 and
  4. Yoshikazu Shimomura1
  1. 1Ophthalmology, Fuchu Hospital, Izumi, Osaka, Japan
  2. 2PL Hospital, Tondabayashi, Osaka, Japan
  1. Correspondence to Dr Takahiro Mizukami; t_mizukami{at}seichokai.or.jp

Abstract

Laser speckle flowgraphy (LSFG) offers a non-invasive, accessible means to evaluate ocular blood flow. A case of a woman in her 70s presenting with 6 months of ocular injection following cataract surgery is presented in this report. LSFG measurements indicated lower mean blur rate (MBR) values in the affected eye compared with the healthy eye, though a decrease was also noted in the healthy eye. Subsequent MRI/magnetic resonance angiography revealed an abnormally high signal in the right cavernous sinus, along with a dilated right superior ophthalmic vein, suggesting a carotid-cavernous fistula (CCF). The patient underwent transvenous embolisation under general anaesthesia at the neurosurgery department, successfully occluding the shunt point and eliminating abnormal venous flow. After successful transvenous embolisation, MBR values improved bilaterally. This case highlights LSFG’s potential as a simple, non-invasive screening tool for CCF, underscoring the need for further research to confirm its diagnostic utility.

  • Clinical neurophysiology
  • Neuroimaging
  • Retina

https://doi.org/10.1136/bcr-2024-263240

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content: TM and SU. The following authors gave final approval of the manuscript: SM and YS. TM is the guarantor. We used Grammarly for grammar correction.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.