The Caliber of Optociliary Shunt Vessels is Associated with Macular Blood Flow and Visual Acuity in Central Retinal Vein Occlusion

Abstract Purpose To define the role of optociliary shunt vessels (OSVs) in eyes with central retinal vein occlusion (CRVO) using optical coherence tomography angiography (OCTA) with macular parameters. Design A retrospective, observational, consecutive case series. Participants Forty-one eyes in 38 consecutive patients with CRVO were analyzed in this study. Methods Optic disc and macula were imaged by swept-source OCTA (3 × 3 mm) as well as by high-quality fundus photography. Main Outcome Measures We compared macular vessel density (VD) and visual acuity between eyes that developed and did not develop OSVs. Further, we measured the diameter of the OSVs and analyzed the correlation with macular VD and visual acuity. Results OSVs were found in 25 eyes (61%). CRVO with OSVs did not show any statistical difference compared to CRVO without OSVs in either macular VD of the total retina (0.31±0.07 and 0.26±0.09, respectively; p=0.0937) or final logMAR best corrected visual acuity (BCVA) (0.30±0.43 and 0.59±0.54, respectively; p=0.0705). The mean OSV diameter was 71±30 μm in CRVO with OSV. The diameter of the OSVs was positively correlated with superficial (r=0.443, p=0.027), deep (r=0.494, p=0.012), and total VD (r=0.491, p=0.013). Furthermore, the OSV diameter was also negatively correlated with logMAR BCVA at the final visit (r=-0.531, p=0.006). Conclusions The results demonstrate that the diameter of the OSVs was associated with macular VD and visual acuity in patients with CRVO. The development of large OSVs on the optic disc may be a good indicator of the maintenance of blood flow in the macula.