Cavernous-dural fistula with secondary angle-closure glaucoma.

Objective: To report a rare case of angle-closure glaucoma, secondary to the rapid development of a choroidal effusion, in a patient with a long-standing cavernous-dural shunt.

Methods: Case report. Investigations included computed tomographic scan, magnetic resonance imaging, and carotid angiography.

Results: The development of the choroidal effusion occurred because of partial thrombosis of the ipsilateral superior ophthalmic vein and cavernous sinus. Drainage of the choroidal effusion resolved the angle-closure glaucoma.

Conclusions: The combination of worsening signs and evidence of thrombosis indicates impending resolution of a cavernous-dural shunt. However, if a choroidal effusion causes angle-closure glaucoma, prompt surgical drainage should be considered to prevent permanent peripheral anterior synechiae formation, with the expectation that the effusion will not recur.