IJAR.2025.188
Type of Article: Original Research
Volume 13; Issue 3 (September 2025)
Page No.: 9292-9296
DOI: https://dx.doi.org/10.16965/ijar.2025.188
Branching Pattern of Central Artery of Retina on the Optic Disc
Muralidhar Reddy Sangam *1, Swatishree Nayak 2.
*1 Additional Professor, Department of Anatomy, All India Institute of Medical Sciences, Guwahati, Assam, India. ORCiD: https://orcid.org/0000-0002-7436-4435
2 Associate Professor, Department of Ophthalmology, All India Institute of Medical Sciences, Guwahati, Assam, India. ORCiD: https://orcid.org/0000-0003-1411-2698
Corresponding Author: Dr. Muralidhar Reddy Sangam, Additional Professor, Department of Anatomy, All India Institute of Medical Sciences, Guwahati, Assam, India.
E-Mail: muralidharsangam@aiimsguwahati.ac.in
ABSTRACT:
Background: The central artery of retina (CRA), on reaching the optic disc, divides into two branches of the first order – superior and inferior. Each of these divides into two branches of the second order – temporal and nasal. Emergence of CRA on the optic disc and further sequence division is not constant. Anomalies in the branching pattern of CRA may be associated with certain optic disc abnormalities like optic disc drusen, optic disc pits, or colobomas. The objectives of the study are: 1) To identify the variations in the number of branches of CRA emerging on the optic disc, 2) to study the variations in the number of branches arising from the main trunk on the optic disc, and 3) to study the variations in the shape of branching pattern of CRA on the optic disc.
Methodology: This observational study was carried out at AIIMS, Guwahati, with the approval of the IEC. Sample size is 160 subjects with 320 fundus images. Subjects with diabetes, hypertension, and other vascular diseases are excluded. The fundus examination was carried out with a fundus camera, and digital photographs were taken. Then the images are magnified to get a clear picture of the optic disc. Images are analyzed by two observers.
Results: In the present study, the CRA emerged on the optic disc as one (82.8%), two (13.1%), and three (4%) branches. Number of first-degree branches observed on the optic disc is two – superior and inferior (74.7%), three – superior, inferior, and nasal (10.9%), superior, inferior, and macular (8.3%), and four – superior, inferior, nasal, and macular (6%). The shape of branching patterns of the central artery on the optic disc observed are X-shape type I (52.5%), X-shape type II (7.5%), X-shape type III (8.1%), Y-shape (10%), inverted Y-shape (8.1%), double V-shape (7.5%), inverted V-shape (4%), and Zeta-shape (2.1%).
Conclusion: Knowledge of the typical branching pattern of the central artery of retina can aid in interpreting diagnostic imaging studies such as fundus photography, fluorescein angiography, indocyanine green (ICG) angiography, fundus autofluorescence, optical coherence tomography, and retinal vascular imaging. It can help in identifying landmarks and interpreting images accurately for diagnostic purposes.
Key words: Central Artery of Retina, Branching, Optic Disc, Variation.
REFERENCES
[1]. Miri M, Amini Z, Rabbani H, Kafieh R. A Comprehensive Study of Retinal Vessel Classification Methods in Fundus Images. J Med Signals Sens. 2017 Apr-Jun;7(2):59-70.
https://doi.org/10.4103/2228-7477.205505
[2]. John V. Forrester, Andrew D. Dick, Paul G. McMenamin, Fiona Roberts, Eric Pearlman. Chapter 1 – Anatomy of the eye and orbit. In: The Eye (Fourth Edition), W.B. Saunders, 2016, Pages 1-102.e2.
https://doi.org/10.1016/B978-0-7020-5554-6.00001-0
[3]. Hayreh SS. Acute retinal arterial occlusive disorders. Prog Retin Eye Res. 2011 Sep;30(5):359-94.
https://doi.org/10.1016/j.preteyeres.2011.05.001
PMid:21620994 PMCid:PMC3137709
[4]. Sobhy, H., Ewis, A., Shatla, E. F. Anatomical variation of the central retinal artery at the optic disc. AAMJ 2012; 10(2):246-270.
[5]. Orlova, T. V., Stepanenko, O. Y. Central retinal artery: branching patterns on the disc of optic nerve. Reports of Morphology, 2022; 28(2):13-19.
https://doi.org/10.31393/morphology-journal-2022-28(2)-02
[6]. Walia S, Maheshwari S. A study of retinal vascular patterns in 200 subjects. J Med Allied Sci. 2024; 14 (1): 6-9.
https://doi.org/10.5455/jmas.206530
[7]. Bhuiyan, A., Hussain, A., Mian, A., Wong, T.Y., Ramamohanarao, K. and Kanagasingam, Y. Biometric authentication system using retinal vessel pattern and geometric hashing. IET Biom., 2017;6:79-88.
https://doi.org/10.1049/iet-bmt.2015.0024
[8]. Hayreh SS. Pathogenesis of occlusion of the central retinal vessels. Am J Ophthalmol. 1971 Nov;72(5):998-1011.
https://doi.org/10.1016/0002-9394(71)91706-5
PMid:5315812
[9]. Mangat HS. Retinal artery occlusion. Surv Ophthalmol. 1995 Sep-Oct;40(2):145-56.
https://doi.org/10.1016/S0039-6257(95)80004-2
PMid:8533103
[10]. Varma DD, Cugati S, Lee AW, Chen CS. A review of central retinal artery occlusion: clinical presentation and management. Eye (Lond). 2013 Jun;27(6):688-97.
https://doi.org/10.1038/eye.2013.25
PMid:23470793 PMCid:PMC3682348
[11]. Spaide RF, Klancnik JM Jr, Cooney MJ. Retinal vascular layers in macular telangiectasia type 2 imaged by optical coherence tomographic angiography. JAMA Ophthalmol. 2015 Jan;133(1):66-73.
https://doi.org/10.1001/jamaophthalmol.2014.3950
PMid:25317692
[12]. Hassanpoor N, Abdolrahimi V, Reza Niyousha M. Central Retinal Vein Occlusion with Three-Retinal Quadrant Involvement: Another Focus on Optic Disc Head Vascular Anatomy Variations. Case Reports in Ophthalmological Medicine. 2023, Article ID 6648367, 3 pages.
https://doi.org/10.1155/2023/6648367
PMid:37941565 PMCid:PMC10630022
[13]. Rishi P, Rishi E, Sharma T, Mahajan S. Hemi-central retinal artery occlusion in young adults. Indian J Ophthalmol. 2010 Sep-Oct;58(5):425-32.
https://doi.org/10.4103/0301-4738.67069
PMid:20689202 PMCid:PMC2992922
[14]. Ewis, S. H., & Elsyedahmed, F.S. Anatomical variation of the central retinal artery at the optic disc. AAMJ, 2012; 10(2):246-270.
[15]. Awan K. J. Arterial vascular anomalies of the retina. Arch Ophthalmol. 1977 Jul; 95(7):1197-1202.
https://doi.org/10.1001/archopht.1977.04450070095007
PMid:880079
