Cracking the mysteries: Arteriovenous malformation presentin
Arteriovenous malformations (AVMs) of the orbit are developmental hamartomas consisting of an abnormal nidus of dysplastic vascular channels with feeding arteries and draining veins and the absence of intervening capillary network. Intraorbital AVMs are rare, and their management represents a challenge for multidisciplinary teams.

A 53-year-old hypertensive female with a history of gradual painless progressive protrusion of the right eye of 8 years' duration presented with sudden worsening of symptoms over 2 weeks. She complained of associated headache. On examination, the best-corrected visual acuity in right eye was 6/12 and in left eye was 6/6. Color vision was normal in both eyes. External eye examination of the right eye showed severe axial proptosis (26 mm), chemosis, and dilated and tortuous episcleral vessels. Pupillary reactions were brisk. Fundus was normal except for minimal tortuosity of vessels. Examination of the left eye was normal.

Routine investigations and thyroid function tests (TFTs) were normal. USG ORBIT showed an irregular heterogeneous soft-tissue mass in the retrobulbar and suprabulbar regions with peripheral vascularity and enlarged thrombosed vein in the right orbit-suspicious of cavernous hemangioma.

Source: Kerala journal of Ophthalmology
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