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Head and Neck
Published in Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno, Understanding Human Anatomy and Pathology, 2018
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno
Most of the blood vessels of the orbital region (Plate 3.34) are branches of the ophthalmic artery, which enters the orbit through the optic canal, inferior to the optic nerve. It gives off the central artery of the retina, then divides into the lacrimal artery, the supratrochlear and supraorbital arteries (Plate 3.22). The major veins of the orbital region are the superior ophthalmic vein, which anastomoses with the angular vein, and the inferior ophthalmic vein (Plate 3.23; described in detail in Section 3.3.2).
Write short notes on the blood supply to the anterior segment of the eye
Published in Nathaniel Knox Cartwright, Petros Carvounis, Short Answer Questions for the MRCOphth Part 1, 2018
Nathaniel Knox Cartwright, Petros Carvounis
The eyelids are supplied by the lateral and medial palpebral arteries. The former is a branch of the lacrimal artery, itself a branch of the ophthalmic artery. The superior and inferior medial palpebral arteries arise from the ophthalmic artery just below the trochlea of superior oblique. After passing behind the lacrimal sac they enter the eyelids.
Ophthalmic artery occlusion following n-butyl cyanoacrylate embolization of an orbital arteriovenous malformation
Published in Orbit, 2023
Marissa K. Shoji, Ann Q. Tran, Wendy W. Lee, Sander R. Dubovy, Andrea L. Kossler
The patient underwent AVM embolization using n-butyl cyanoacrylate (NBCA) glue with a plan for subsequent surgical excision. Her pre-embolization angiogram showed a 2.5 × 4.5 cm nidus primarily supplied by the lacrimal artery arising from the second segment of the right ophthalmic artery with otherwise normal internal carotid artery and intracranial vasculature (Figure 3A). Intraoperative superselective catheterization of the ophthalmic artery was implemented, and provocative testing including the retinal Wada test was performed twice prior to NBCA injection. The microcatheter was subsequently advanced 1 centimeter beyond the origin of the central retinal artery, and NBCA mixed with iodized oil was injected. Despite these precautions, the post-embolization angiogram was notable for delayed filling of the ophthalmic artery and central retinal artery without obvious thrombosis (Figure 3B), and the patient reported complete loss of vision in her right eye. Ocular massage, intraocular pressure lowering drops, anterior chamber tap, heparin drip, dexamethasone, and acetazolamide were rapidly attempted to restore vision without success. Dilated fundus exam showed evidence of central retinal artery occlusion with lack of arterial filling and regions of ischemia (Figure 4A). Optical coherence tomography of the retina revealed severe swelling of the nerve fiber layer and inner and outer retina with abnormalities of the underlying choroid suggesting involvement of both arterial and choroidal circulation (Figure 4B). Fluorescein angiography and indocyanine green angiography demonstrated hypofluorescence and hypocyanosis consistent with retinal and choroidal infarction (Figure 5A,B).