Bilateral optic disk edema with macular exudates as the manifesting sign of a cerebral arteriovenous malformation

PURPOSE: To report that an unruptured arteriovenous malformation without hydrocephalus may manifest with bilateral optic disk edema and macular exudates. METHODS: We examined an 11-year-old girl with an unruptured frontal lobe arteriovenous malformation who had decreased visual acuity, bilateral optic disk edema, and bilateral macular exudates. RESULTS: The arteriovenous malformation was treated with partial embolization. A ventriculoperitoneal shunt was placed, but the patient's visual function did not improve. CONCLUSIONS: Although optic disk edema with macular exudates may be caused by neuroretinitis, ophthalmologists should consider increased intracranial pressure as a cause of these ophthalmoscopic findings, especially when atypical features are present, such as bilaterality, lack of vitreous cells, lack of infectious risk factors, absent spontaneous venous pulsations, or no significant visual recovery.