Anatomic characteristics of the ophthalmic and posterior ciliary arteries.

ABSTRACT

BACKGROUND: There is little documentation of the course and relations of the ophthalmic artery (OA) and posterior ciliary arteries (PCAs). METHODS: The anatomic characteristics of the OA and PCAs were determined from a dissection of 19 neoprene-injected cadaver heads. RESULTS: The intraorbital OA had three segments, considering its relation to the optic nerve in the sagittal plane. The first segment extended from the point where the OA entered the orbit to its curving point. The second segment coursed superomedially from the inferolateral part of the optic nerve, crossing the optic nerve either superiorly or inferiorly. The third segment extended from the curving point of the superomedial distal portion of the second segment to the vessel's termination. The OA was deviated at the junction of its first and second segments, defined as its "angle"; and at the junction of the second and third segments, defined as its "bend." The PCAs arose from the first OA segment, the angle of the OA, the second OA segment and the OA bend. The patterns of branching of the PCAs were medial and lateral and medial, lateral, and superior. The superior PCA and the lateral PCA arose mainly from the angle of the OA, whereas the medial PCA arose from the curving point of the OA. The most frequently observed PCA pattern was a medial PCA and a lateral PCA. The average diameters of the medial PCA, the superior PCA, and the lateral PCA were 0.65, 0.48, and 0.68 mm, respectively. In all cases, pial arteries branching from the PCA and supplying the optic sheath were observed to form a vascular plexus on the optic sheath. The OA and PCAs were surrounded by a network of sympathetic nerves. CONCLUSIONS: Because the most common pattern of PCAs is a medial and lateral branch, a surgical approach to the orbit from those directions carries a higher risk of damage to those vessels than a superior or inferior approach.