Central Retinal Vein Occlusion Complicating Spontaneous Carotid-Cavernous Fistula

To the Editor.  —We read with interest Pollock and Miller's recent letter concerning a case of central retinal vein occlusion (CRVO) complicating a dural carotid-cavernous fistula (DCCF). Our own experience with a similar patient in whom the fistula was angiographically documented suggests that this complication may be more common than previously appreciated.

Report of a Case.  —A 47-year-old woman was first seen in August 1981 for redness and abnormal protrusion of the left eye of three months' duration. She also complained of an intermittent whistling sound in the left ear. She had no history of head trauma, diabetes, hypertension, or glaucoma. Visual acuity was 20/25 OD and 20/30 OS. The left eye showed dilated episcleral vessels, slight chemosis, and 4 mm of proptosis. No bruit or limitation of eye movement was noted. Intraocular pressure (IOP) was 14 mm Hg OD and 24 mm Hg OS. The fundi were normal. Orbital