Insights in the diagnosis of a retinal arteriovenous malformation

Objective: To describe a patient with vitreous hemorrhage due to peripheral retinal ischemia and neovascularization, who was diagnosed with an underlying retinal arteriovenous malformation.

Methods: A 15-year old girl presented with sudden-onset painless visual loss in the right eye. She underwent a full ophthalmologic work-up.

Results: BCVA was less than 20/400 in the right eye, 20/20 in the left eye. Intraocular pressure and anterior segment examination were unremarkable. Fundoscopy revealed an impenetrable vitreous hemorrhage in the right eye. The left eye was completely unremarkable. Examination during a 23-gauge pars plana vitrectomy showed dilated, tortuous arteriovenous vessels extending from the optic disc and peripheral neovascularization. A clinical diagnosis of retinal arteriovenous malformation was made. During surgery, a peripheral retinal photocoagulation was completed to avoid rebleeding. During the post-operative period, a fluorescein angiography demonstrated addit...