Retina

CLINICAL SCIENCES

Orbital Arteriovenous Malformations
Sunil Warrier, MBBS; Venkatesh C. Prabhakaran, MS, MRCOphth; Alejandra Valenzuela, MD; Tim J. Sullivan, FRANZCO; Garry Davis, FRANZCO; Dinesh Selva, FRANZCO

Objective: To present the clinical features, management, and outcomes in a series of patients with orbital arteriovenous malformations (AVMs). Methods: Clinical records of patients with orbital AVMs confirmed using angiography were reviewed as a retrospective, noncomparative, interventional case series. Results: Eight patients (3 women and 5 men) with uni-

tion of extraocular movements, and diplopia (1 patient each, 12%). All of the patients except 1 underwent surgical resection, with 3 (38%) receiving preoperative embolization of feeder vessels; all of the patients had initial resolution of manifestations after treatment.
Conclusions: Angiography is essential for diagnosis and

lateral AVMs and a mean age of 39 years (median, 36.5 years; range, 26-70 years) were reviewed. Findings existed for an average of 11.2 years before diagnosis and included periocular mass (7 patients, 88%); periocular edema, pulsation/bruit, proptosis, episcleral congestion, and previous trauma (4 patients each, 50%); elevated intraocular pressure (3 patients, 38%); pain and reduced visual acuity (2 patients each, 25%); and restric-

for planning the management of orbital AVMs. Treatment depends on patient-specific features and includes observation, embolization, and surgical excision or combined preoperative embolization/excision. Given their vascular nature, the main cause of poor management outcomes is perioperative hemorrhage. Outcomes after a multidisciplinary approach are good, with few recurrences reported at follow-up. Arch Ophthalmol. 2008;126(12):1669-1675 giographic evidence and outcomes after intervention. A review of the literature to better define the features and management of orbital AVMs was also undertaken.
METHODS This is a multicenter,