Bilateral dural arteriovenous malformations simulating dysthyroid ophthalmopathy

Area of Science:

• Ophthalmology
• Neurology
• Vascular Surgery

Background:

• Dural arteriovenous malformations (AVM) can present with subtle or dramatic ocular findings.
• Accurate diagnosis of intracranial vascular lesions is crucial for appropriate management.
• Ophthalmologists must consider AVMs in the differential diagnosis of orbital and visual disturbances.

Observation:

• A patient presented with bilateral congestive exophthalmos, a condition that closely resembled dysthyroid ophthalmopathy.
• The ocular symptoms were attributed to bilateral dural arteriovenous malformations.
• Unilateral dural AVMs are known to cause monocular signs that can mimic orbital diseases.

Findings:

• The reported case involved bilateral dural AVMs presenting as bilateral proptosis.
• The clinical presentation mimicked dysthyroid ophthalmopathy, a common cause of exophthalmos.
• The ocular manifestations of the dural AVMs underwent spontaneous resolution.

Implications:

• This case underscores the importance of considering dural AVMs in the differential diagnosis of bilateral exophthalmos.
• Ophthalmologists should be aware that dural AVMs can present with signs mimicking thyroid eye disease.
• The spontaneous resolution of ocular symptoms in this case suggests potential natural regression or response to unknown factors.