Article Text

Download PDFPDF
Characterising collateral vessels in eyes with branch retinal vein occlusions using widefield swept-source optical coherence tomography angiography
  1. Noam D Rudnick1,2,
  2. Filippos Vingopoulos1,2,
  3. Jay C Wang2,3,
  4. Itika Garg1,2,
  5. Ying Cui2,4,
  6. Ying Zhu2,5,
  7. Rongrong Le2,6,
  8. Raviv Katz1,2,
  9. Yifan Lu1,2,
  10. Nimesh A Patel1,
  11. John B Miller1,2
  1. 1Retina Service, Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
  2. 2Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Retinal Imaging Laboratory, Boston, Massachusetts, USA
  3. 3Department of Ophthalmology & Visual Science, Yale University School of Medicine, New Haven, Connecticut, USA
  4. 4Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
  5. 5Eye Center of Xiangya Hospital, Department of Ophthalmology, Central South University, Changsha, China
  6. 6Department of Ophthalmology, Wenzhou Medical University, Wenzhou, China
  1. Correspondence to Dr John B Miller, Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, USA; john_miller{at}


Background/aims To characterise the morphology, location and functional significance of both macular and extramacular collateral vessels (CVs) in patients with a history of branch retinal vein occlusion (BRVO) using widefield swept-source optical coherence tomography angiography (WF SS OCTA).

Methods Patients with a history of BRVO underwent WF SS OCTA testing to acquire 12×12 mm images, which were evaluated for CVs and non-perfusion area (NPA). Region of interest analysis of individual CVs was performed to identify correlations between CV size, depth and retinal location. Mixed effects multivariate regression analyses of factors associated with NPA and visual acuity (VA) were performed.

Results Fifty-five CVs were identified in 28 BRVO eyes from 27 patients. CVs were identified in 42.9% (12/28) of eyes with a history of BRVO, and of these, 45.5% (25/55) were extramacular. The majority of CVs (87.3%, 48/55) coursed through both the superficial and the deep capillary plexus (DCP), while a subset (12.7%, 7/55) were strictly superficial. No CVs were found to course strictly through the DCP alone. CV depth increased with distance from the optic disc (p=0.011) and CV size increased with distance from the fovea (p=0.005). There were no statistically significant associations between CVs and NPA, or between CVs and VA.

Conclusions WF SS OCTA revealed that a large fraction of CVs that form after BRVO are extramacular, and the morphology of CVs varies as a function of retinal location. Depth-resolved study of CVs may offer valuable insights on the pathophysiological mechanisms leading to the development of macular oedema.

  • retina
  • imaging

Data availability statement

Data are available on reasonable request.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Data availability statement

Data are available on reasonable request.

View Full Text


  • Twitter @FVingopoulos, @itikagarg

  • NDR, FV and JCW contributed equally.

  • Presented at This work was presented in part at the Association for Research in Vision and Ophthalmology (ARVO), in May 2021

  • Contributors Concept and design: NR, FV, JW, NAP and JBM; acquisition, analysis or interpretation of data: NR, FV, JW, IG, YC, YZ, RL, RK and YL; drafting original manuscript: NR and FV, critically revising manuscript: NR, FV, JW, IG, YC, YZ, RL, RK, YL, NAP and JBM; obtained funding: JBM; supervision: JBM. NDR and JBM are guarantors.

  • Funding Lions International Fund (Grant 530 125 and 530869).

  • Competing interests NAP is a consultant for Alimera Sciences, Alcon, Allergan and Genentech. JBM is a consultant for Alcon, Allergan, Carl Zeiss, Sunovion and Genentech.

  • Provenance and peer review Not commissioned; externally peer reviewed.