The authors report a case of congenital arteriovenous communication of the retinal near the macula, associated with a central retinal vein occlusion. This occlusion only affected the inferior half-retina, especially the area surrounding the arteriovenous anastomoses. Laser photocoagulation was applied to areas of peripheral ischemia. After a 12 month follow-up, a marked decrease of visual acuity occurred, attributable to severe ischemia and edema in the posterior pole. An extension of the peripheral capillary non perfusion required additional laser treatment. We also observed the reduction in caliber of the arteriovenous anastomosis. The association of congenital arteriovenous communication and retinal vein occlusion is rare. The clinical and pathogenic features are discussed. Photocoagulation of extensive peripheral capillary occlusion is recommended in order to prevent neovascular complications.

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