Opticociliary shunt (collaterals) vessels
 

The disc shows dilated venous loop. Unlike neovascularization, there are no thin or wispy. Look for: old central retinal vein occlusion such flamed  haemorrhages, tortous retinal vein or panphotocoagulation scars for ischaemiccentral  retinal vein occlusion   evidence of retrobulbar tumour such as proptosis and choroidal foldings.

Questions:

1. How can you differentiate shunt vessels from neovascularization?

Answer
The appearance: in neovascularization, the blood vessels tend to be thin and wispy.
In doubtful cases, fluorescein angiography is useful. In neovascularization, leakage is observed but not in shunt vessels.

2. What is the differential diagnosis of opticociliary shunt vessels?

Answer
meningioma
optic nerve glioma
old central retinal vein occlusion
glaucoma
chronic papilloedema
idiopathic

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