During her lecture, “Visual Field Defects: Looking Beyond Glaucoma,” which took place yesterday, at 9 a.m., Mika Moy, OD, FAAO, Dipl. AAO, revealed that visual field (VF) testing can save lives. Specifically, she discussed a case in which an intracranial arteriovenous malformation (AVM) was diagnosed after routine VF testing. 

AVM defined
An intracranial AVM occurs when the brain’s arteries attach to the veins sans capillaries between them. The condition is dangerous because it places the patient at risk for embolization, which can result in death.

Highlighted case
The case Dr. Moy described was of a gentleman who presented due to pingueculitis, but also had an inferior right homonymous, (slightly) incongruous hemianopsia and an abnormal glaucoma hemifield test, as revealed by routine testing.

Specifically, an MRI showed a 2.5 x 3 x 3.5 cm AVM in the left parietal-occipital lobe, a large feeding artery in the left middle cerebral area, and a large draining vein in the sagittal sinus.

Because an intracranial AVM typically has no symptoms until rupture, Dr Moy noted that the case illustrated the importance of the OD’s role in diagnosing these patients, potentially saving their lives.

“I hope my lecture helped the attendee differentiate between a VF defect that may, at first glance, appear glaucomatous, but with further inspection prove to be from a different disease process,” Dr. Moy said, of her lecture.

Also included in her lecture: a discussion on choroidal nevi and astrocytoma. OM