Dr.DEEPAK SONI

Dr. Sunita Sabarwal, DR. DEEPAYAN SARKAR, Dr.HARSHA SAXENA

Abstract

CCF are rare entity, misdiagnosed majority of times specially when only few sign and symptoms are present on presentation. A 60 years-old-female, with hypothyroidism, presented with diminution of vision in LE associated with diplopia, congestion and proptosis and fundus features of stasis retinopathy. BCVA and IOP was 20/60 and in 24mmHg. Mildly dilated left SOV was missed on early imaging. In view of systemic history and unilateral ocular congestion differentials considered were vascular malformations, CST, inflammatory processes such as scleritis, with vortex vein blockage and thyroid orbitopathy. Based on MRI findings in favour of left CST, patient treated accordingly but remained unresponsive. Digital subtraction angiography (DSA) performed; diagnosis of indirect type C CCF is made. Treated successfully with conservative management. Doppler, CT and MR angiography are used for demonstrating specific signs; however, the gold-standard remains DSA for timely diagnosis of indirect CCF.