Ventral and Dorsal Persistent Primitive Ophthalmic Arteries

BACKGROUND: Before the development of the adult ophthalmic artery (OA), the primitive maxillary artery (MA), the primitive dorsal OA, and the primitive ventral OA contribute to the vascularization of early ocular structures, whereas the primitive olfactory artery (OlfA) forms in the vicinity of the optic vesicle. These vessels are involved in several OA origin variants. OBJECTIVE: To clarify the developmental history of the OA, emphasizing in particular the criteria used to define persistent primitive OAs. METHODS: Eight rare variants relevant to the discussion of aberrant OA origins are presented. RESULTS: Five abnormal anatomic configurations are described including (1) OAs branching from the cavernous internal carotid artery (ICA) involving a persistent primitive MA, (2) OAs originating from the distal supraclinoid ICA involving persistent primitive ventral or dorsal OAs, (3) an OA originating from the anterior cerebral artery (ACA) involving a persistent primitive OlfA, (4) a persistent primitive OlfA, and (5) infraoptic ACAs involving the persistent primitive MA, OlfA, and OA. CONCLUSION: Discrepancies regarding the identification of persistent primitive OAs appear to result from a misinterpretation of the literature. Notably, an OA arising from the cavernous segment of the ICA derives from a primitive MA, whereas an OA arising from the ACA represents the partial persistence of a primitive OlfA; neither corresponds to a persistent primitive OA. Two new observations of this latter variant, which is exceptional, are presented. ABBREVIATIONS: ACA, anterior cerebral artery DSA, digital subtraction angiography ICA, internal carotid artery ILT, inferolateral trunk MA, maxillary artery MMA, middle meningeal artery MRA, magnetic resonance angiography OA, ophthalmic artery OlfA, olfactory artery PComA, posterior communicating artery SOF, superior orbital fissure