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Case report


Imaging of dual ophthalmic arteries: identification of the central retinal artery.

Louise LouwJohan SteylEugene Loggenberg
Date of Submission: 09-Mar-2014, Date of Acceptance: 09-Jun-2014, Date of Web Publication: 30-Jul-2014.
Corresponding Author:
Corresponding Author

Louise Louw

Department of Otorhinolaryngology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
E-mail: gnanll@ufs.ac.za

Corresponding Author:
Corresponding Author

Louise Louw

Department of Otorhinolaryngology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa.
E-mail: gnanll@ufs.ac.za

DOI: 10.4103/2156-7514.137833 Facebook Twitter Google Linkedin

ABSTRACT


Identification of the origin of the central retinal artery (CRA) is imperative in tailoring angiographic studies to resolve a given clinical problem. A case with dual ophthalmic arteries (OAs), characterized by different origins and distinct branching patterns, is documented for training purposes. Pre-clinical diagnosis of a 9-year-old child who presented with a sharp wire in the left-side eyeball was primarily corneal laceration. For imaging, a selected six-vessel angiographic study with the transfemoral approach was performed. Embolization was not required and the wire could be successfully removed. Right-side OA anatomy was normal, while left-side dual OAs with external carotid artery (ECA) and internal carotid artery (ICA) origins were seen. The case presented with a left-side meningo-ophthalmic artery (M-OA) anomaly via the ECA, marked by a middle meningeal artery (MMA) (origin: Maxillary artery; course: Through foramen spinosum) with normal branches (i.e. anterior and posterior branches), and an OA variant (course: Through superior orbital fissure) with a distinct orbital branching pattern. A smaller OA (origin: ICA; course: Through optic foramen) with a distinct ocular branching pattern presented with the central retinal artery (CRA). The presence of the dual OAs and the M-OA anomaly can be explained by disturbed evolutionary changes of the primitive OA and stapedial artery during development. The surgical interventionist must be aware of dual OAs and M-OA anomalies with branching pattern variations on retinal supply, because of dangerous extracranial-intracranial anastomotic connections. It is of clinical significance that the origin of the CRA from the ICA or ECA must be determined to avoid complications to the vision.
Keywords: Dual Ophthalmic Arteries, Imaging, Meningo-ophthalmic Artery Anomaly, Source Of Central Retinal Artery, Source Of Retinal Artery

Cited in 4 Documents

  1. Beatriz Simão-Parreira, Diogo Cunha-Cabral, Hélio Alves, Susana Maria Silva and José Paulo Andrade (2019) Morphology and Navigational Landmarks of the Cranio-orbital Foramen in a Portuguese Population. Ophthalmic Plastic and Reconstructive Surgery 35(2):141. doi: 10.1097/IOP.0000000000001188
  2. Adamantios Michalinos, Sofia Zogana, Evangelos Kotsiomitis, Antonios Mazarakis and Theodore Troupis (2015) Anatomy of the Ophthalmic Artery: A Review concerning Its Modern Surgical and Clinical Applications. Anatomy Research International 2015:1. doi: 10.1155/2015/591961
  3. Francesco Belotti, Marco Ferrari, Francesco Doglietto, Marco Angelo Cocchi, Davide Lancini, Barbara Buffoli, Piero Nicolai, Marco Maria Fontanella, Roberto Maroldi, Manfred Tschabitscher and Luigi Fabrizio Rodella (2016) Ophthalmic artery originating from the anterior cerebral artery: anatomo-radiological study, histological analysis, and literature review. Neurosurg Rev 39(3):483. doi: 10.1007/s10143-016-0715-x
  4. Sinan Balci and Anıl Arat (2019) Unusual ophthalmic artery origin: Implications for intraarterial chemotherapy of retinoblastoma. Interv Neuroradiol :159101991985273. doi: 10.1177/1591019919852737

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