The central retinal artery (retinal artery) branches off the ophthalmic artery

Ophthalmic artery

The ophthalmic artery is the first branch of the internal carotid artery distal to the cavernous sinus. Branches of the OA supply all the structures in the orbit as well as some structures in the nose, face and meninges...

, running inferior to the optic nerve

Optic nerve

The optic nerve, also called cranial nerve 2, transmits visual information from the retina to the brain. Derived from the embryonic retinal ganglion cell, a diverticulum located in the diencephalon, the optic nerve doesn't regenerate after transection.-Anatomy:The optic nerve is the second of...

 within its dura

Dura mater

The dura mater , or dura, is the outermost of the three layers of the meninges surrounding the brain and spinal cord. It is derived from Mesoderm. The other two meningeal layers are the pia mater and the arachnoid mater. The dura surrounds the brain and the spinal cord and is responsible for...

l sheath to the eyeball.

Course

It pierces the optic nerve close to the eyeball, sending branches over the internal surface of the retina

Retina

The vertebrate retina is a light-sensitive tissue lining the inner surface of the eye. The optics of the eye create an image of the visual world on the retina, which serves much the same function as the film in a camera. Light striking the retina initiates a cascade of chemical and electrical...

, 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 focussed after passing through the pupil

Pupil

The pupil is a hole located in the center of the iris of the eye that allows light to enter the retina. It appears black because most of the light entering the pupil is absorbed by the tissues inside the eye. In humans the pupil is round, but other species, such as some cats, have slit pupils. In...

 and the lens

Lens (anatomy)

The crystalline lens is a transparent, biconvex structure in the eye that, along with the cornea, helps to refract light to be focused on the retina. The lens, by changing shape, functions to change the focal distance of the eye so that it can focus on objects at various distances, thus allowing a...

 is a circular area called the macula

Macula

The macula or macula lutea is an oval-shaped highly pigmented yellow spot near the center of the retina of the human eye. It has a diameter of around 5 mm and is often histologically defined as having two or more layers of ganglion cells...

. The center of this circular area is the fovea

Fovea

The fovea centralis, also generally known as the fovea , is a part of the eye, located in the center of the macula region of the retina....

. The fovea and a small area surrounding it are not supplied by the central retinal artery or its branches, but instead by the choroid

Choroid

The choroid, also known as the choroidea or choroid coat, is the vascular layer of the eye, containing connective tissue, and lying 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...

.

Supplies

The central retinal artery supplies all the nerve fibers that form the optic nerve that carries the visual information to the occipital lobe

Occipital lobe

The occipital lobe is the visual processing center of the mammalian brain containing most of the anatomical region of the visual cortex. The primary visual cortex is Brodmann area 17, commonly called V1...

 cerebral cortex

Cerebral cortex

The cerebral cortex is a sheet of neural tissue that is outermost to the cerebrum of the mammalian brain. It plays a key role in memory, attention, perceptual awareness, thought, language, and consciousness. It is constituted of up to six horizontal layers, each of which has a different...

, including those that reach over the fovea.

Pathology

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).

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 CRAO.

Additional images

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 Opthalmic 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).

External links

• Diagram at suncoastretina.com ("Retinal artery occlusion")