Central retinal artery

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Central retinal artery
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The ophthalmic artery and its branches. (Central retinal artery visible at center.)
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Pulsatile blood flow in the central retinal artery revealed by laser Doppler holography
Details
Source ophthalmic artery
Vein central retinal vein
Supplies retina
Identifiers
Latin arteria centralis retinae
MeSH D012161
TA98 A12.2.06.024
TA2 4470
FMA 49879
Anatomical terminology

The central retinal artery (retinal artery) branches off the ophthalmic artery, running inferior to the optic nerve within its dural sheath to the eyeball.

Contents

Structure

The central retinal artery pierces the eyeball close to the optic nerve, sending branches over the internal surface of the retina, and these terminal branches are the only blood supply to the larger part of it.

The central part of the retina where the light rays are focused after passing through the pupil and the lens is a circular area called the macula. The center of this circular area is the fovea. The fovea and a small area surrounding it are not supplied by the central retinal artery or its branches, but instead by the choroid.

The central retinal artery is approximately 160 micrometres in diameter. [1] [2]

Variation

In some cases—approximately 20% of the population—there is a branch of the ciliary circulation called the cilio-retinal artery which supplies the retina between the macula and the optic nerve, including the nerve fibers from the foveal photoreceptors. If this artery is present, the central vision will be preserved even in case of central retinal artery occlusion (CRAO).

Development

The central retinal artery is formed from the proximal part of the hyaloid artery after atrophy of its distal part has formed the hyaloid canal. [3]

Function

The central retinal artery supplies blood to all the nerve fibers that form the optic nerve, which carries the visual information to the lateral geniculate nucleus of the thalamus, including those that reach over the fovea. Its blood flow can be revealed by fluorescein angiography or laser Doppler imaging. [4]

Clinical significance

Thus if the central retinal artery gets occluded, there is complete loss of vision in that eye even though the fovea is not affected. The entire retina (with the exception of the fovea) becomes pale and swollen and opaque while the central fovea still appears reddish (this is because the choroid color shows through). This is the basis of the famous "Cherry red spot" seen on examination of the retina on funduscopy of a central retinal artery occlusion (CRAO).

However it should be remembered that the Cilio retinal artery itself is a branch of the Short Posterior Ciliary Arteries which is derived from the Ophthalmic Artery. Therefore, its possible for the cilio retinal artery itself to occlude causing significant visual loss in the perfused macula region (surrounding visual field will remain intact).

Other animals

In dogs, it is the continuation of the long ciliary artery.[ citation needed ]

Additional images

Related Research Articles

<span class="mw-page-title-main">Retina</span> Part of the eye

The retina is the innermost, light-sensitive layer of tissue of the eye of most vertebrates and some molluscs. The optics of the eye create a focused two-dimensional image of the visual world on the retina, which then processes that image within the retina and sends nerve impulses along the optic nerve to the visual cortex to create visual perception. The retina serves a function which is in many ways analogous to that of the film or image sensor in a camera.

<span class="mw-page-title-main">Optic nerve</span> Second cranial nerve, which connects the eyes to the brain

In neuroanatomy, the optic nerve, also known as the second cranial nerve, cranial nerve II, or simply CN II, is a paired cranial nerve that transmits visual information from the retina to the brain. In humans, the optic nerve is derived from optic stalks during the seventh week of development and is composed of retinal ganglion cell axons and glial cells; it extends from the optic disc to the optic chiasma and continues as the optic tract to the lateral geniculate nucleus, pretectal nuclei, and superior colliculus.

<span class="mw-page-title-main">Macula</span> Oval-shaped pigmented area near the center of the retina

The macula (/ˈmakjʊlə/) or macula lutea is an oval-shaped pigmented area in the center of the retina of the human eye and in other animals. The macula in humans has a diameter of around 5.5 mm (0.22 in) and is subdivided into the umbo, foveola, foveal avascular zone, fovea, parafovea, and perifovea areas.

<span class="mw-page-title-main">Vitreous body</span> Gel in eyeballs

The vitreous body is the clear gel that fills the space between the lens and the retina of the eyeball in humans and other vertebrates. It is often referred to as the vitreous humor or simply "the vitreous". Vitreous fluid or "liquid vitreous" is the liquid component of the vitreous gel, found after a vitreous detachment. It is not to be confused with the aqueous humor, the other fluid in the eye that is found between the cornea and lens.

<span class="mw-page-title-main">Choroid</span> Vascular layer of the eye, containing connective tissue, and lying between the retina and the sclera

The choroid, also known as the choroidea or choroid coat, is a part of the uvea, the vascular layer of the eye. It contains connective tissues, and lies between the retina and the sclera. The human choroid is thickest at the far extreme rear of the eye, while in the outlying areas it narrows to 0.1 mm. The choroid provides oxygen and nourishment to the outer layers of the retina. Along with the ciliary body and iris, the choroid forms the uveal tract.

<span class="mw-page-title-main">Fovea centralis</span> Small pit in the retina of the eye responsible for all central vision

The fovea centralis is a small, central pit composed of closely packed cones in the eye. It is located in the center of the macula lutea of the retina.

This is a partial list of human eye diseases and disorders.

The visual field is "that portion of space in which objects are visible at the same moment during steady fixation of the gaze in one direction"; in ophthalmology and neurology the emphasis is on the structure inside the visual field and it is then considered “the field of functional capacity obtained and recorded by means of perimetry”.

<span class="mw-page-title-main">Fluorescein angiography</span> Technique for examining the circulation of the retina and choroid of the eye

Fluorescein angiography (FA), fluorescent angiography (FAG), or fundus fluorescein angiography (FFA) is a technique for examining the circulation of the retina and choroid using a fluorescent dye and a specialized camera. Sodium fluorescein is added into the systemic circulation, the retina is illuminated with blue light at a wavelength of 490 nanometers, and an angiogram is obtained by photographing the fluorescent green light that is emitted by the dye. The fluorescein is administered intravenously in intravenous fluorescein angiography (IVFA) and orally in oral fluorescein angiography (OFA). The test is a dye tracing method.

<span class="mw-page-title-main">Optic disc</span> Optic nerve head, the point of exit for ganglion cell axons leaving the eye

The optic disc or optic nerve head is the point of exit for ganglion cell axons leaving the eye. Because there are no rods or cones overlying the optic disc, it corresponds to a small blind spot in each eye.

<span class="mw-page-title-main">Ophthalmic artery</span> Artery of the head

The ophthalmic artery (OA) is an artery of the head. It is the first branch of the internal carotid artery distal to the cavernous sinus. Branches of the ophthalmic artery supply all the structures in the orbit around the eye, as well as some structures in the nose, face, and meninges. Occlusion of the ophthalmic artery or its branches can produce sight-threatening conditions.

<span class="mw-page-title-main">Long ciliary nerves</span>

The long ciliary nerves are 2-3 nerves that arise from the nasociliary nerve (itself a branch of the ophthalmic branch (CN V1) of the trigeminal nerve (CN V)). They enter the eyeball to provide sensory innervation to parts of the eye, and sympathetic visceral motor innervation to the dilator pupillae muscle.

<span class="mw-page-title-main">Long posterior ciliary arteries</span>

The long posterior ciliary arteries are arteries of the orbit. There are long posterior ciliary arteries two on each side of the body. They are branches of the ophthalmic artery. They pass forward within the eye to reach the ciliary body where they ramify and anastomose with the anterior ciliary arteries, thus forming the major arterial circle of the iris.The long posterior ciliary arteries contribute arterial supply to the choroid, ciliary body, and iris.

<span class="mw-page-title-main">Short posterior ciliary arteries</span>

The short posterior ciliary arteries are a number of branches of the ophthalmic artery. They pass forward with the optic nerve to reach the eyeball, piercing the sclera around the entry of the optic nerve into the eyeball.

Ocular ischemic syndrome is the constellation of ocular signs and symptoms secondary to severe, chronic arterial hypoperfusion to the eye. Amaurosis fugax is a form of acute vision loss caused by reduced blood flow to the eye; it may be a warning sign of an impending stroke, as both stroke and retinal artery occlusion can be caused by thromboembolism due to atherosclerosis elsewhere in the body. Consequently, those with transient blurring of vision are advised to urgently seek medical attention for a thorough evaluation of the carotid artery. Anterior segment ischemic syndrome is a similar ischemic condition of anterior segment usually seen in post-surgical cases. Retinal artery occlusion leads to rapid death of retinal cells, thereby resulting in severe loss of vision.

Central retinal artery occlusion (CRAO) is a disease of the eye where the flow of blood through the central retinal artery is blocked (occluded). There are several different causes of this occlusion; the most common is carotid artery atherosclerosis.

<span class="mw-page-title-main">Central retinal vein</span> Vein in the retina of the eye

The central retinal vein is a vein that drains the retina of the eye. It travels backwards through the centre of the optic nerve accompanied by the central retinal artery before exiting the optic nerve together with the central retinal artery to drain into either the superior ophthalmic vein or the cavernous sinus.

<span class="mw-page-title-main">Mammalian eye</span>

Mammals normally have a pair of eyes. Although mammalian vision is not so excellent as bird vision, it is at least dichromatic for most of mammalian species, with certain families possessing a trichromatic color perception.

<span class="mw-page-title-main">Cherry-red spot</span>

A cherry-red spot is a finding in the macula of the eye in a variety of lipid storage disorders and in central retinal artery occlusion. It describes the appearance of a small circular choroid shape as seen through the fovea centralis. Its appearance is due to a relative transparency of the macula; storage disorders cause the accumulation of storage material within the cell layers of the retina, however, the macula, which is relatively devoid of cellular layers, does not build up this material, and thus allows the eye to see through the macula to the red choroid below.

Sickle cell retinopathy can be defined as retinal changes due to blood vessel damage in the eye of a person with a background of sickle cell disease. It can likely progress to loss of vision in late stages due to vitreous hemorrhage or retinal detachment. Sickle cell disease is a structural red blood cell disorder leading to consequences in multiple systems. It is characterized by chronic red blood cell destruction, vascular injury, and tissue ischemia causing damage to the brain, eyes, heart, lungs, kidneys, spleen, and musculoskeletal system.

References

  1. Lee, K. E.; Klein, B. E. K.; Klein, R.; Meuer, S. M. (2007). "Association of Retinal Vessel Caliber to Optic Disc and Cup Diameters". Investigative Ophthalmology & Visual Science. 48 (1): 63–7. doi:10.1167/iovs.05-1203. PMID   17197517.
  2. Dorner, G. T.; Polska, E; Garhöfer, G; Zawinka, C; Frank, B; Schmetterer, L (2002). "Calculation of the diameter of the central retinal artery from noninvasive measurements in humans". Current Eye Research. 25 (6): 341–5. doi:10.1076/ceyr.25.6.341.14231. PMID   12789540.
  3. Larsen's human embryology 2009, p. 610
  4. Puyo, L., M. Paques, M. Fink, J-A. Sahel, and M. Atlan. "In vivo laser Doppler holography of the human retina." Biomedical optics express 9, no. 9 (2018): 4113-4129.