AIM: To analyze the clinical features and differential diagnosis of carotid cavernous fistula(CCF)first examined in ophthalmology department, and improve the diagnosis and treatment level among ophthalmologist.

METHODS:This was a retrospective case study. The details of clinical manifestations, diagnosis, differential diagnosis and treatment in 11 cases of CCF first examined in ophthalmology department were analyzed.

RESULTS:Nine patients had a history of trauma. The clinical ocular manifestation was mainly pulsatile proptosis, and the disease may be misdiagnosed as orbital inflammatory pseudotumor, orbital aneurysm, and thyroid associated ophthalmopathy. Obliteration of the fistula by intravascular balloon embolization was the current mainstay treatment after DSA examination.

CONCLUSION: With enhanced awareness of the disease, careful query of history, combined with the characteristic clinical manifestations, and utilizing cerebralangiography examination can improve the diagnosis rate. Endovascular embolization is a suitable treatment of the CCF with good prognosis.