The role of choroidal optical coherence tomography for follow-up of carotid cavernous fistula with anterior drainage

Background To evaluate the role of the choroidal vascularity index (CVI) and the tortuosity index (TI), along with choroidal thickness measurements, in follow-up for anteriorly draining carotid cavernous fistulas (CCF) that would otherwise necessitate an invasive carotid angiogram. Methods In this longitudinal observational study, analysis of enhanced depth imaging spectral domain optical coherence tomography (SD-EDI-OCT) images of 22 patients with angiographically proven unilateral CCF with anterior drainage was performed for subfoveal choroidal thickness (SFCT), central foveal thickness (CFT), CVI and TI. Baseline measurements were compared with those taken at the last visit after occlusion of the fistula. Results Both in the clinically affected and unaffected eyes, there was a significant decrease in CFT ( p = 0.015 and p = 0.005, respectively), SFCT ( p = 0.000 for both eyes), CVI ( p = 0.002 and 0.001, respectively) and all three TI parameters, including inferior ( p