[The formation and involution of the optociliary vein during the course of central retinal vein occlusion]

Formation of collateral pathways by veins on the optic nerve head is sometimes observed during the resolution of a central retinal vein occlusion (CRVO). However, no cases have been reported which documented the formation and involution of these collateral pathways during the resolution of a CRVO.

A 56-year-old man with a non-ischemic CRVO was followed over a 10-year period by ophthalmoscopy, fluorescein angiography (FA), and indocyanine green angiography (IA). Initial examination revealed only mild arteriosclerosis and absence of the optociliary vein (OCV) in the right eye. Approximately 9 years later, the patient returned with non-ishemic CRVO, and FA demonstrated a prolongation of the retinal circulation time to 12.1 seconds (normal < 11.0 seconds). Monitoring of this patient during treatment disclosed development of an OCV on the optic nerve head and gradual decrease in the retinal hemorrhage. In FA, the retinal circulation time was shortened and returned to normal. IA verified an outflow through the OCV into choroidal veins. Later, ophthalmoscopy showed a narrowing of the diameter of the OCV.

We suggest that the OCV developed to drain blood from retinal veins to the vortex veins through choroidal veins to compensate for the slowing of retinal blood outflow. The reperfusion of the central retinal vein was accompanied by the narrowing of the OCV.