Dual ophthalmic arteries: a new case.

Area of Science:

• Ophthalmology
• Vascular Anatomy
• Interventional Radiology

Background:

• Retinoblastoma treatment often involves intraarterial chemotherapy.
• Understanding orbital vascular anatomy is crucial for successful treatment delivery.
• Variations in the ophthalmic artery can affect treatment strategies.

Observation:

• A unique case of dual ophthalmic arteries originating from the internal carotid artery was identified in a retinoblastoma patient.
• The larger caudal ophthalmic artery arose from the cavernous internal carotid artery, while the smaller cranial artery originated from the supraclinoid segment.
• Superselective ophthalmic angiography revealed a fusion (anastomosis) between these dual arteries within the orbit.

Findings:

• This is the first reported case of dual ophthalmic arteries with distinct cavernous and supracavernous origins that fuse within the orbit.
• The central retinal artery originated from the cranial of the two ophthalmic arteries.
• The presence and nature of anastomosis between dual ophthalmic arteries were confirmed via superselective angiography.

Implications:

• Accurate pre-treatment angiographic analysis of orbital vasculature is essential for retinoblastoma patients.
• Identifying dual ophthalmic arteries and their anastomosis is critical for selecting the appropriate artery for intraarterial chemotherapy.
• This knowledge can help prevent complications during intraarterial treatment of retinoblastoma.