Bilateral ophthalmic arteries arising from the cavernous segments of the internal carotid arteries and entering the orbits via the superior orbital fissures: a case diagnosed by magnetic resonance angiography

Abstract Purpose To describe a case of bilateral ophthalmic arteries (OAs) arising from the cavernous segments of the internal carotid arteries (ICAs) and entering the orbits via the superior orbital fissures (SOFs). Methods A 75-year-old woman with a cerebral aneurysm underwent follow-up cranial magnetic resonance angiography (MRA) using a 3-T scanner. MRA was performed using a standard three-dimensional time-of-flight technique. Results MRA revealed an aneurysm at the junction of the left ICA and posterior communicating artery (PCoA), which showed no interval change over the preceding 9 months. The right OA arose from the cavernous segment of the ICA at a typical location and entered the orbit via the SOF. The left OA also arose from the cavernous segment of the ICA and entered the orbit via the SOF; however, its origin was approximately 5 mm distal to that of the right OA. Conclusion An OA arising from the cavernous segment of the ICA and entering the orbit via the SOF was previously considered to represent a persistent primitive dorsal OA. However, this variation is now thought to result from persistence of the lateral branch of the primitive maxillary artery and is most commonly associated with an origin from the inferolateral trunk. In the present case, both OAs arose from the cavernous segments of the ICAs, and the left OA originated from an unusually distal portion of the cavernous ICA. To our knowledge, no similar case has been reported in the English-language literature.