Ophthalmic artery

The ophthalmic artery (OA) is a branch off the C6 segment of the internal carotid artery (ICA).

Gross anatomy

Origin

OA arises medial to the anterior clinoid process as the ICA exits the cavernous sinus. It originates from the antero- or supero-medial surface of the ICA.

Course

OA passes into the orbit via the optic canal. It has numerous branches which are often grouped into those that supply the orbital content and those that supply the globe and related structures.

Branches
Orbital group
Ocular group
  • central retinal artery: although rarely seen, the choroidal blush should be seen on all angiograms
  • long posterior ciliary arteries
  • short posterior ciliary arteries
  • anterior ciliary artery
  • muscular artery

A useful mnemonic to remember the branches of the ophthalmic artery is:

Variant anatomy

Embryologically, the orbit has dual supply from the supraorbital branch (which later becomes the middle meningeal artery) and from the OA but there can be often be variation:

  • communicating branch between the ophthalmic and middle meningeal artery is present; most frequently passes through the superior orbital fissure (up to 50%)
  • when multiple branches are present (15%) then an additional small foramen (or multiple foramen) lateral to the superior orbital fissure are present (foramen of Hyrtl or the meningo-orbital foramen)
    • the connecting branch is known as sphenoidal artery or recurrent meningeal artery or orbital branch of the middle meningeal branch
  • regression of proximal ophthalmic artery and entire orbit is supplied by the middle meningeal artery

These variants are important to recognise as embolisation of a tumour supplied by the external carotid artery (e.g. meningioma or haemangiopericytoma) can result in blindness. This is reported as the most common variant origin and in this case OA enters the orbit via the superior orbital fissure or via its own canal.

Variations in origin or branching patterns may be common:

  • middle meningeal artery can arise from the ophthalmic artery
  • ophthalmic artery origin from the middle meningeal artery, middle cerebral artery or posterior communicating artery
  • cavernous origin of ophthalmic artery is less common

Neuroanatomy
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Article Information

rID: 4764
Section: Anatomy
Synonyms or Alternate Spellings:

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Cases and Figures

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    Figure 1: labelled ICA angiogram
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    Figure 2: orbital apex diagram
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    Case 1
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    Case 2: middle meningeal from ophthalmic
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