The complete anatomy of the ophthalmic artery: a meta-analysis with clinical implications

The ophthalmic artery (OA) plays a crucial role in supplying blood to various ocular and orbital structures through its numerous branches. This meta-analysis aims to provide a comprehensive analysis of the anatomical variations of the OA based on the available data present in the literature. Major online medical databases, including PubMed, Embase, Scopus, and Web of Science were systematically reviewed to identify and collect all relevant studies addressing the anatomical characteristics, morphometry, and variations of the OA. The overall length of the first part of the OA was found to be 4.57 mm, the second part being 3.62 mm, and the third part measuring 5.26 mm. The overall mean diameter was described as 1.51 mm. The most common location of the optic nerve (ON) was found to be inferior with respect to the OA, with a pooled prevalence of this variation being 82.31%. Concerning the entrance into the optic canal, the OA was found most commonly to enter inferolaterally in respect to the ON, with a pooled prevalence of 54.64%. This meta-analysis provides essential anatomical reference data on the ophthalmic artery, including its morphometry, branching patterns, and relationship to the optic nerve. These findings have direct clinical relevance in improving the safety and precision of procedures such as aneurysm clipping, embolization of dural arteriovenous fistulas, and management of orbital trauma, ultimately aiding surgical planning and minimizing the risk of visual or vascular complications.