Accurate Course and Relationships of the Intraorbital Part of the Ophthalmic Artery in the Sagittal Plane

Abstract

Introduction: Knowledge of variations in the course and distribution of the intraorbital part of ophthalmic artery (OA) is necessary for the diagnosis and treatment of anterior cranial and orbital disorders.

Material: 38 human cadaver dissections to demonstrate the microsurgical anatomy of the intraorbital part of the OA were studied in three stages, considering its neighbourhood with the optic nerve in the sagittal plane.

Results: The first part of the OA was located on the inferolateral aspect of the optic nerve in 89.47%. The diameter and the length of the first part of the OA were 1.69±0.34 mm and 7.58±0.89 mm. 73.68% of the cases crossed the optic nerve superiorly, and 26.31% inferiorly. The diameter and length of the second part of the OA were as 1.52±0.29 mm and 4.12±0.85 mm. The diameter and length of the third part of the OA were 1.07±0.18 mm and 4.12±0.85 mm. The first branch of the intraorbital part of the OA was the central retinal artery in 26.31% of the specimens.

Conclusion: A better understanding of the vascular anatomy of the orbit should allow for the modification of surgical techniques to reduce bleeding during biopsy or excision of orbital structures.

Key words

ophthalmic artery - orbit - microsurgical approach - lacrimal artery - anterior ethmoidal artery - central retinal artery - posterior ciliary artery - muscular branches

References

• 1 Hayreh SS, Dass R. The ophthalmic artery. II. Intra-orbital course.  Brit J Ophthal. 1962;  46 165-185
• 2 Hayreh SS. The ophthalmic artery. III. Branches.  Brit J Ophthal. 1962;  46 212-246
• 3 Jimenez-Castellanos J, Carmona A, Castellanos L, Catalina-Herrera CJ. Microsurgical anatomy of the human ophthalmic artery. A mesoscopic study of its origin, course and collateral branches.  Surg Radiol Anat. 1995;  17 139-143
• 4 Jo-Osvatic A, Basic N, Jukic T, Nikolic V, Stimac D. Topoanatomic relations of the ophthalmic artery viewed in four layers.  Surg Radiol Anat. 1999;  21 371-375
• 5 Erdogmus S, Govsa F. Importance of the anatomic features of the lacrimal artery for orbital approaches.  J Craniofac Surg. 2005;  16 957-964
• 6 Erdogmus S, Govsa F. Topography of the posterior arteries supplying the eye and relations to the optic nerve.  Acta Ophthalmol Scand. 2006;  84 642-649
• 7 Erdogmus S, Govsa F. The anatomic landmarks of ethmoidal arteries for the surgical approaches.  J Craniofac Surg. 2006;  17 280-285
• 8 Berthelot JL, Hureau J. Clinical anatomical study of the macroscopic anastomoses of the ophthalmic artery in the periorbital region.  Anat Clin. 1987;  3 271-278
• 9 Lang J, Kageyama I. The ophthalmic artery and its branches, measurements and clinical importance.  Surg Radiol Anat. 1990;  12 83-90
• 10 Kerty E. The ophthalmology of internal carotid artery dissection.  Acta Ophthalmol Scand. 1999;  77 418-421
• 11 Natori Y, Rhoton  Jr  AL. Transcranial approach to the orbit: microsurgical anatomy.  J Neurosurg. 1994;  81 78-86
• 12 Lee WC, Ku PKM, Hasselt AC von. New guidelines for endoscopic localization of the anterior ethmoidal artery: A cadaveric study.  Laryngoscope. 2000;  110 1173-1178
• 13 De Santis M, Anderson KJ, King DW, Nielson J. Variability in relationships of arteries and nerves in the human orbit.  Anat Anz. 1984;  157 227-231
• 14 Duccase A, Delattre JF, Segal A, Desphieux JL, Flament JB. Anatomical basis of the surgical approach to the medial wall of the orbit.  Anat Clin. 1985;  7 15-21
• 15 Couch JM, Somers ME, Gonzalez C. Superior oblique muscle dysfunction following anterior ethmoidal artery ligation for epistaxis.  Arch Ophthalmol. 1990;  108 1110-1113
• 16 Govsa F, Erturk M, Kayalioglu G, Pinar Y, Ozer M A, Ozgur T. Neuro-arterial relations in the region of the optic canal.  Surg Radiol Anat. 1999;  21 329-335
• 17 Forbes G. Vascular lesions in the orbit.  Neuroimaging Clin N Am. 1996;  6 113-122
• 18 Sato S, Suga S, Ohira T, Takayama H, Kawase T. Aneurysm of the ophthalmic artery trunk.  Acta Neurochir (Wien). 1999;  141 321-322
• 19 Lieb WE, Flaharty PM, Ho A, Sergott RC. Color Doppler imaging of the eye and orbit. A synopsis of a 400 case experience.  Acta Ophthalmol Suppl. 1992;  204) 50-54
• 20 Martini E, Guiducci M, Campi L, Cavallini GM. Ocular blood flow evaluation in injured and healthy fellow eyes.  Eur J Ophthalmol. 2005;  15 48-55
• 21 Ettl A, Salomonowitz E, Koornneef L, Zonneveld FW. High-resolution MR imaging anatomy of the orbit. Correlation with comparative cryosectional anatomy.  Radiol Clin North Am. 1998;  36 1021-1045
• 22 Ettl A, Zwrtek K, Daxer A, Salomonowitz E. Anatomy of the orbital apex and cavernous sinus on high-resolution magnetic resonance images.  Surv Ophthalmol. 2000;  44 303-323
• 23 Aviv RI, Casselman J. Orbital imaging: Part 1. Normal anatomy.  Clin Radiol. 2005;  60 279-287
• 24 Erdogmus S, Govsa F. Anatomic features of the intracranial and intracanalicular portions of ophthalmic artery: for the surgical procedures.  Neurosurg Rev. 2006;  29 213-218
• 25 Maillot CI, Froelich S, Kehrli P. Ophthalmic artery, optic nerve and meninges: reciprocal relations.  J Neuroradiol. 2000;  27 93-100
• 26 Mittra RA, Sergott RC, Flaharty PM, Lieb WE, Savino PJ, Bosley TM, Hedges  Jr  TR. Optic nerve decompression improves hemodynamic parameters in papilledema.  Ophthalmology. 1993;  100 987-997
• 27 Liu Q, Rhoton  Jr  AL. Middle meningeal origin of the ophthalmic artery.  Neurosurgery. 2001;  49 401-407
• 28 Kikuchi K, Kowada M. Case report: saccular aneurysm of the intraorbital ophthalmic artery.  Br J Radiol. 1994;  67 1134-1135
• 29 Kleinschmidt A, Sullivan TJ, Mitchell K. Intraorbital ophthalmic artery aneurysms.  Clin Experiment Ophthalmol. 2004;  32 112-114
• 30 Maiuri F, Donzelli R, Divitiis O de, Fusco M, Briganti F. Anomalous meningeal branches of the ophthalmic artery feeding meningiomas of the brain convexity.  Surg Radiol Anat. 1998;  20 279-284
• 31 Batista LL. Intraorbital ophthalmic artery aneurysm.  Neuroradiology. 2003;  45 335-336
• 32 Pretterklieber ML, Schindler A, Krammer EB. Unilateral persistence of the dorsal ophthalmic artery in man.  Acta Anat (Basel). 1994;  149 300-305
• 33 Sudakevitch T. The variation in the system of the trunks of the posterior ciliary arteries.  Br J Ophthal. 1947;  31 738-760

Correspondence