Purpose: To describe a choroidal detachment resulting from an indirect carotid-cavernous fistula. Methods: An observational case report was evaluated, and a literature review was performed. Results: A 97-year-old woman presented with unilateral dilated episcleral vessels. A posterior segment examination showed serous choroidal detachments in all 4 quadrants with associated retinal hemorrhages. A subsequent cerebral angiogram showed a Barrow type D carotid-cavernous fistula. The patient was observed, and the serous choroidal detachments slowly improved. Conclusions: In a patient with a choroidal detachment of unclear etiology, it is important to consider carotid-cavernous fistula in the differential diagnosis.
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