Scattered depressions with temporal preponderance in visual field test coexisting with optic disc temporal atrophy in cerebral arteriovenous malformation
A 22-year-old man suffering from visual disturbance, starting 5-years ago and gradually decreasing over time, presented to our ophthalmology department. Although his previous ophthalmic examination data were not available, he had no family history of any systemic or ophthalmologic disorders. At presentation, his best corrected visual acuity (BCVA) was 20/50 in the right and 20/100 in the left eye. Dilated fundoscopic examination revealed bilateral optic disc temporal pallor (). Visual evoked potentials (VEP) revealed delayed P100 latencies particularly observed in the smaller patterns in both eyes (). Pupillary light reflex was normal in both eyes. Automated visual field testing (Humphrey Instruments Inc., San Leandro, CA, USA) demonstrated scattered depressions with temporal preponderance resembling incomplete bitemporal hemianopsia (). Retinal nerve fiber layer (RNFL) map analyzed with spectral domain optical coherence tomography (SD-OCT) confirmed the presence of optic disc temporal atrophy (). Brain magnetic resonance imaging (MRI) and cerebral computed tomography angiography (CTA) revealed AVM, which was located adjacent to inferomedial portion of the posterior limb of the right internal capsule at the level of lateral ventricle ( and ). Chiasmal compression or atrophy was not observed. AVM was draining into the choroidal veins at the level of the posterior horn of right lateral ventricle.