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Archivos de la Sociedad Española de Oftalmología (English Edition) Anterior segment OCT, Schlemm’s canal, and carotid-cavernous fistula: Reflecti...
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Clinical Case
Available online 24 June 2026

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

OCT de segmento anterior, canal de Schlemm y fístula carótido-cavenosa: reflexiones acerca de un caso clínico
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J. González Martín-Moroa,b,
Corresponding author
, V. Altares Mateosa
a Department of Ophthalmology, University Hospital of Henares, Coslada, Madrid, Spain
b University Francisco de Vitoria, Madrid, Spain
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Abstract

We rerport a 69-year-old man who presented with diplopia. He had a conjunctival injection with corkscrew-vessels, proptosis, and sixth cranial nerve palsy in his right eye (RE), and was diagnosed with a right carotid–cavernous fistula (CCF). Intraocular pressure was within normal limits. Gonioscopic examination revealed a pinkish appearance of the trabecular meshwork, but the Schlemm’s canal could not be identified on anterior segment optical coherence tomography (OCT). We discuss the potential usefulness and limitations of OCT in the assessment of the Schlemm’s canal in CCF.

Keywords:
Carotid-cavernous fistula
Schlemm’s canal
Glaucoma
Ocular hypertension
Optical coherence tomography
Resumen

Comunicamos el caso de un varón de 69 años de edad que acudió a nuestro centro por diplopía. Presentaba inyección en cabeza de medusa, proptosis y paresia de VI nervio craneal en su ojo derecho (OD), y fue diagnosticado de fístula carótido-cavernosa (FCC) derecha. No presentaba hipertensión ocular. La malla trabecular en la exploración gonioscópica mostraba un aspecto sonrosado, sin que pudiera identificarse el canal de Schlemm en la tomografía de coherencia óptica (OCT). Reflexionamos acerca de la potencial utilidad y posibles limitaciones de la OCT en la evaluación del canal de Schlemm en la FCC.

Palabras clave:
Fístula carótido-cavenosa
Canal de Schlemm
Glaucoma
Hipertension ocular
Tomografía de coherencia óptica

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