The authors present a retrospective medical notes review which aimed to understand associations between retinal venous malformations (RVM) and cerebral vascular malformations (CVM). Cases of known CVM over a four-year period were identified. The data extracted from medical records included demographics, ophthalmic findings (fundus images where available) and MRI reports. A total of 610 cases of CVM were identified, of which 26% had a documented ophthalmic assessment. Different levels of fundus examination were available, with a level of evidence attached to each. The prevalence of RVM was 0%, with 95% confidence intervals of up to 6.5%. Other retinal pathology was identified including epiretinal membrane, diabetic retinopathy and hypertensive retinopathy / retinal vein occlusion. Commonly detected neuro-ophthalmic abnormalities directly related to the CVM included visual field defects (up to 65%) and cranial nerve palsies (up to 52%). The findings of this study weaken the association between CVM and RVM found in previous studies. However, a high prevalence of visual impairment in cases of CVM were identified, highlighting the need for visual assessment. The authors suggest a clinical decision-making algorithm for asymptomatic RVM. The following limitations are acknowledged; small sample size, retrospective design and only high-risk CVM were included. A future prospective multi-centre study is required including wider CVM subtypes is needed.
Prevalence of retinal venous malformations in patients with cerebral cavernous or arteriovenous malformations.
Chan KS, Daulton MR, Reddy VS, et al.
JOURNAL OF NEURO-OPHTHALMOLOGY
2024;44:226-31.
