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Show Journal of Clinical Neuro- ophthalmology 11( 4): 278- 279, 1991. Feature Photo © 1991 Raven Press, Ltd., New York Multiple Cilioretinal Arteries and Dysplasia of the Optic Disc Luiza H. L. Barroso, M. D., Nicola K. Ragge, M. R. C. P., F. C. Ophth., and William F. Hoyt, M. D. We present here three fundus images from asymptomatic children that demonstrate multiple sectorial cilioretinal arteries in combination with elevated dysplastic optic discs ( Figs. 1 and 2). COMMENT Cilioretinal arteries usually supply only a small portion of the fundus and are most often located on the temporal side of the disc. Multiple cilioretinal arteries are rare. Several authors ( 1- 3) have documented the occurrence of three or more cilioretinal arteries in a single eye. Collier, in 1957, recorded, but did not illustrate, one example in which all four quadrants of the retina were supplied by cilioretinal arteries ( 1). Nettleship recognized that in lower mammals the cilioretinal vessels playa more important role in the blood supply of the retina. Under these circumstances, the central retinal artery is often rudimentary ( 4). Hayreh From the Ophthalmology Department of Hospital dos Servidores do Estado do Rio de Janeiro, Brazil ( L. H. L. B.); Neuroophthalmology Unit, Departments of Neurological Surgery, Neurology, and Ophthalmology ( N. K. R., W. F. H.), University of California, San Francisco, California, U. S. A. Address correspondence and reprint requests to Dr. William F. Hoyt at Neuro- ophthalmology Unit, Department of Neurosurgery, 126 UC Hospital, San Francisco, CA 94143, U. S. A. 278 published histological details of a primate eye supplied exclusively by cilioretinal arteries ( 5). Dysplastic discs have been mentioned in association with cilioretinal arteries, but in most of these cases cavitary disc anomalies were seen ( 1). In our examples, the optic discs are small, elevated, and have no optic cup. Cilioretinal arteries appear to supply all but a minor portion of the retina. A rudimentary central retinal artery is present in at least two of our cases ( Fig. 1). Acknowledgment: Dr Ragge is a Keeler Scholar, supported by Keeler Ltd, Clewer Hill Road, Windsor, Berks., U. K. and also by grants from the Wellcome Trust, London, U. K. and the Royal Society of Medicine, London, U. K. REFERENCES 1. Collier M. Frequence des vaisseaux cilioretiniens, leur rapport avec les ametropies, leur association avec d'autres anomalies du fond de l'oeil. Bull Soc Ophthalmol Fr 1957; 9: 598- 601. 2. Jackson E. Cilioretinal and other anomalous retinal vessels. Ophthal Rev 1911; 30: 264- 96. 3. Justice J, Lehmann RP. Cilioretinal arteries. Arch Ophthalmol 1976; 94: 1355- 8. 4. Nettleship E. Notes on the blood vessels of the optic disc in some of the lower animals. Trans Ophthalmol Soc UK 1905; 25: 338- 59. 5. Hayreh 55. The cilioretinal arteries. Brit J Ophthalmol 1963; 47: 71- 89. FIG. 1. Right ( A) and left ( B) fundus of the same child, demonstrating multiple cilioretinal arteries emerging from the margin of the disc ( black arrows) and a rudimentary central retinal artery ( open arrow). Of note is the small, dysplastic nature of the optic discs. FIG. 2. Right fundus of another child, demonstrating highly dysplastic optic disc with abnormal vascular pattern, including multiple cilioretinal arteries ( black arrows) and anomalous venous drainage. The open arrow indicates either a rudimentary central retinal artery or another cilioretinal artery. A B, |
