[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Head and neck](https://durgical.com/en/anatomy/region/head-and-neck/) › Central retinal artery [Cardiovascular system](https://durgical.com/en/anatomy/system/cardiovascular-system/) · [Head and neck](https://durgical.com/en/anatomy/region/head-and-neck/) # Central retinal artery The central retinal artery runs inside the optic nerve and spreads over the retina to feed it; a blockage causes sudden, painless loss of vision. [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=head_neck&select=central_retinal_artery&side=r) Opens in the Durgical app, no sign-up needed. ## What it is Vessels running inside the optic nerve and spreading over the retina. ## What it does Feed the inner retina; a blocked artery causes sudden painless vision loss. ## Key points - Occlusion: sudden painless loss of vision in one eye, a pale retina with a cherry-red spot, a relative afferent pupillary defect and segmented (boxcar) blood columns; it is handled as a stroke equivalent - Main causes: emboli from the carotid artery (bright cholesterol Hollenhorst plaques) or the heart; giant cell arteritis must be ruled out in older patients - Amaurosis fugax, a brief curtain over one eye, is a transient ischaemic attack of the retina and has the same workup ## Key facts **Origin** Ophthalmic artery; enters the optic nerve ~1 cm behind the eye **Branches** Four branches over the retina (superior/inferior, nasal/temporal); end arteries **Supplies** Inner retina (occlusion = sudden painless loss of vision; cherry-red spot) ## Relations **Course** Arises from the [ophthalmic artery](https://durgical.com/en/anatomy/ophthalmic-artery/) near the [optic canal](https://durgical.com/en/anatomy/optic-canal/), runs forward below the [optic nerve](https://durgical.com/en/anatomy/optic-nerve/), pierces its dural sheath about 1 cm behind the eyeball and travels in the centre of the nerve to emerge at the [optic disc](https://durgical.com/en/anatomy/optic-disc/), where it divides **Deep** Over the [retina](https://durgical.com/en/anatomy/retina/) its branches run in the nerve fibre layer under the internal limiting membrane, facing the [vitreous body](https://durgical.com/en/anatomy/vitreous-body/); where they cross veins they share a sheath (arteriovenous crossings) ## How to find it On fundoscopy its branches are the narrower, brighter red vessels leaving the disc, with a central light reflex; they are thinner than the veins beside them. Following the arcades out from the disc shows the four main branches. ## Examination - Fundoscopy: whitened, swollen retina, cherry-red spot, thin arteries, sometimes an embolus visible at a branch point - Swinging flashlight test: a relative afferent pupillary defect in the affected eye - Inflammatory markers and temporal artery assessment in older patients, looking for giant cell arteritis ## On imaging Fluorescein angiography shows delayed arterial filling; OCT shows a thick, bright inner retina early and thinning later; the stroke workup includes carotid imaging, an ECG and imaging of the heart. ## Clinical notes - Branch retinal artery occlusion causes a sector of field loss matching the territory supplied - Hypertensive and arteriosclerotic changes are seen directly in its branches: narrowing, copper or silver wiring, and nicking where arteries cross veins - Central retinal vein occlusion, of its companion vein, looks very different: swollen tortuous veins and haemorrhages across the whole retina ## Anatomical variants - Cilioretinal artery: a branch of the posterior ciliary circulation emerging at the temporal edge of the disc in a sizeable minority of eyes (figures vary between texts); it can spare central vision in an occlusion ## Development It is the persistent proximal part of the hyaloid artery, whose segment crossing the vitreous to the [lens](https://durgical.com/en/anatomy/lens/) regresses before birth. ## Related conditions - [Central retinal artery occlusion](https://durgical.com/en/conditions/central-retinal-artery-occlusion/) - [Hypertensive retinopathy](https://durgical.com/en/conditions/hypertensive-retinopathy/) - [Transient ischaemic attack](https://durgical.com/en/conditions/transient-ischaemic-attack/) - [Diabetic retinopathy](https://durgical.com/en/conditions/diabetic-retinopathy/) - [Giant cell arteritis](https://durgical.com/en/conditions/giant-cell-arteritis/) ## Test yourself Think of the answer, then tap the question to see it. ## What are the signs of central retinal artery occlusion? Sudden painless loss of vision in one eye, a pale retina with a cherry-red spot, a relative afferent pupillary defect and segmented (boxcar) blood columns. ## Which cause must be ruled out in an older patient with central retinal artery occlusion? Giant cell arteritis; other main causes are emboli from the carotid artery (Hollenhorst plaques) or the heart. ## What is amaurosis fugax and how is it investigated? A brief curtain over one eye: a transient ischaemic attack of the retina, with the same workup as a stroke. ## How can a cilioretinal artery change the effect of a central retinal artery occlusion? This branch of the posterior ciliary circulation, present in a sizeable minority of eyes, can spare central vision. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/anatomy/central-retinal-artery/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** arteria centralis retinae TA2 4470 **Official Spanish (DeCS)** Arteria Retiniana DeCS D012161 **English (TA2)** Central retinal artery **Also called** Zinn's artery ## Related - [Optic nerve](https://durgical.com/en/anatomy/optic-nerve/) - [Retina](https://durgical.com/en/anatomy/retina/) - [Optic disc](https://durgical.com/en/anatomy/optic-disc/) Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=12579); [Central Retinal Artery Occlusion](https://www.ncbi.nlm.nih.gov/books/NBK470354/); [Anatomy, Head and Neck, Eye Arteries](https://www.ncbi.nlm.nih.gov/books/NBK537063/); Tratado de anatomía humana (9.ª ed.), tomo II, Libro IV, sección 2 Arterias, caps. I-III (sistema de la arteria pulmonar; aorta y ramas del cayado hasta la carótida interna). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/central-retinal-artery/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/central-retinal-artery/