Biomaterial Database

Microsurgical anatomy of the central retinal artery. 2006

Satoshi Tsutsumi, and Albert L Rhoton

Department of Neurological Surgery, University of Florida, Gainesville, Florida 32610, USA.

OBJECTIVE To define the microsurgical anatomy of the central retinal artery (CRA) and to provide a guide to avoiding damage to it during surgery. METHODS The anatomic characteristics of the CRA and small arteries distributed to the optic sheath were examined in 109 orbits. The origin, course, and site of entry of the artery into the optic sheath and the distance between the orbital apex and the site of entry into the sheath were examined. RESULTS The CRAs originated directly from the intraorbital ophthalmic artery or in a common trunk with a posterior ciliary or a muscular branch. The CRAs most commonly originated on the inferomedial side of the ophthalmic artery an average of 8.4 mm distal to the orbital end of the optic canal. They penetrated the optic sheath near the junction of the middle and anterior thirds of the length of the intraorbital optic nerve an average of 18.6 mm distal to the optic canal. More than 70% of CRAs penetrated near the midline of the lower surface of the optic sheath, 21% entered the inferomedial surface, and 7% the inferolateral or lateral surface of the optic sheath. Only one CRA gave off a branch before penetrating the nerve. CONCLUSIONS The CRA is at risk of being damaged or occluded during procedures involving a large part of the orbit. Procedures directed along the lower half of the proximal two-thirds of the optic sheath have the greatest risk of interrupting the artery.

UI	MeSH Term	Description	Entries
D008866	Microsurgery	The performance of surgical procedures with the aid of a microscope.
D009420	Nervous System	The entire nerve apparatus, composed of a central part, the brain and spinal cord, and a peripheral part, the cranial and spinal nerves, autonomic ganglia, and plexuses. (Stedman, 26th ed)	Nervous Systems,System, Nervous,Systems, Nervous
D009880	Ophthalmic Artery	Artery originating from the internal carotid artery and distributing to the eye, orbit and adjacent facial structures.	Arteries, Ophthalmic,Artery, Ophthalmic,Ophthalmic Arteries
D009900	Optic Nerve	The 2nd cranial nerve which conveys visual information from the RETINA to the brain. The nerve carries the axons of the RETINAL GANGLION CELLS which sort at the OPTIC CHIASM and continue via the OPTIC TRACTS to the brain. The largest projection is to the lateral geniculate nuclei; other targets include the SUPERIOR COLLICULI and the SUPRACHIASMATIC NUCLEI. Though known as the second cranial nerve, it is considered part of the CENTRAL NERVOUS SYSTEM.	Cranial Nerve II,Second Cranial Nerve,Nervus Opticus,Cranial Nerve, Second,Cranial Nerves, Second,Nerve, Optic,Nerve, Second Cranial,Nerves, Optic,Nerves, Second Cranial,Optic Nerves,Second Cranial Nerves
D009915	Orbit	Bony cavity that holds the eyeball and its associated tissues and appendages.	Eye Socket,Eye Sockets,Orbits,Socket, Eye,Sockets, Eye
D012161	Retinal Artery	Central retinal artery and its branches. It arises from the ophthalmic artery, pierces the optic nerve and runs through its center, enters the eye through the porus opticus and branches to supply the retina.	Central Retinal Artery,Arteries, Central Retinal,Arteries, Retinal,Artery, Central Retinal,Artery, Retinal,Central Retinal Arteries,Retinal Arteries,Retinal Arteries, Central,Retinal Artery, Central
D002102	Cadaver	A dead body, usually a human body.	Corpse,Cadavers,Corpses
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014656	Vascular Surgical Procedures	Operative procedures for the treatment of vascular disorders.	Vascular Surgery,Procedure, Vascular Surgical,Procedures, Vascular Surgical,Surgical Procedure, Vascular,Surgical Procedures, Vascular,Vascular Surgical Procedure,Surgeries, Vascular,Surgery, Vascular,Vascular Surgeries