Retinal arteriovenous malformation presenting with retinal vein occlusion during pregnancy

To report the clinical course and treatment outcomes of a patient with a previously undiagnosed retinal arteriovenous malformation who developed retinal vein occlusions and cystoid macular edema during pregnancy.

Observational case report.

A 26-year-old pregnant woman at 26 weeks' gestation with no medical history presented with decreased vision. On examination, a retinal arteriovenous malformation associated with multiple vein occlusions and cystoid macular edema was found in the affected eye. No intracranial arteriovenous malformations were found on neuroimaging. The patient was not immediately treated and cystoid macular edema persisted on subsequent follow-up visits. After the patient stopped breastfeeding, she was treated with a single intravitreal injection of 1.25 mg bevacizumab, which resulted in resolution of cystoid macular edema and improvement in visual acuity from 6/200 to 20/200.

The clinical course of retinal arteriovenous malformations may be altered by pregnancy and treatment with intravitreal Avastin (bevacizumab) may be beneficial for cystoid macular edema secondary to retinal vein occlusions in this setting.