Exploring Optociliary Shunt Vessel Differentials: A Case Report

Optociliary shunt vessels are a vascular phenomenon commonly associated with optic nerve sheath meningiomas. Other common, less critical associations with optociliary shunt vessels include retinal vein occlusions, chronic glaucoma, chronic papilledema, optic nerve drusen, and optic nerve glioma. Shunt vessels may occur in a congenital or acquired setting with the latter appearing more frequently. The following case report explores a new onset optociliary shunt vessel occurring in a relatively healthy 49 year old female without pertinent ocular or systemic history. The patient presented to the optometry clinic for an annual examination and reported no visual or ocular complaints relating to this incidental finding. Upon discovery of an optociliary shunt vessel in 2012 which was not present in 2009, concern for an orbital tumor warranted timely MRI of the orbits to be completed. Appropriate management includes prompt neuro-imaging to exclude orbital masses. If orbital masses are ruled out, a proper work-up for other considerations should be explored. As such, this report will primarily focus on acquired optociliary shunt vessel differentials and its respective management. Due to the asymptomatic nature of vessel formation, optometrists must be able to properly detect and manage this abnormality as it is commonly an incidental finding during routine examination. By presenting this case, we aim to enhance the optometrist’s role and ability to recognize, diagnose, and manage optociliary shunt vessels and its underlying causes which can become vision and life-threatening.