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Ophthalmology and Visual Sciences

Optociliary shunt vessels

Optociliary shunt vessels

Category(ies): Glaucoma, Neuro-ophthalmology, Retina
Contributor: Johanna Beebe, MD
Photographer: Carol Chan, CRA

This 87-year-old male has alongstanding history of primary open angle glaucoma. His optic nerve is significantly cupped with a marked number of optociliary shunt vessels. There are several drusen in the peripapillary region.

Optociliary shunt vessels are collateral vessels connecting the choroidal and the retinal vasculature. The differential diagnosis for acquired optociliary shunt vessels commonly includes central retinal vein occlusion, chronic glaucoma, chronic papilledema, or an optic nerve sheath meningioma. Optociliary shunt vessels can be differentiated from neovascularization of the disc by their large caliber and lack of leakage on fluorescein angiogram.