Homonymous Hemianopia Secondary to an Intracranial Bleed from an Arteriovenous Malformation

This case demonstrates a homonymous hemianopia resulting from hemorrhage secondary to a ruptured intracranial arteriovenous malformation (AVM), providing grounds for illustration and discussion of the correlations between localization of this lesion on cerebral imaging and resultant visual field and optical coherence tomography ganglion cell complex defects. Prevalence of AVMs is estimated at approximately 1 in 10,000 in the United States. Most are asymptomatic until hemorrhage and may cause various effects on the visual system depending on their location. Here, we present a case of an AVM affecting the left parieto-occipital junction with a resultant right homonymous hemianopia demonstrated on Humphrey visual field testing. This case furthermore provides an example of focal retinal ganglion cell layer thinning as a result of transsynaptic retrograde degeneration from this post chiasmal lesion.