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Ophthalmology

Visualization of Short Posterior Ciliary Artery Insertion Due to Posterior Staphyloma and Myopic Chorioretinal Atrophy

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JAMA Ophthalmology

Published Online: April 20, 2023

Ophthalmic Images

Article Information and Disclosures

Giovanna Vieira Moreira, MD¹;

Eduardo Ferrari Marback, PhD²;

Ricardo Luz Leitão Guerra, MSc¹

Author Affiliations

¹Department of Ophthalmology, Clínica de Olhos Leitão Guerra, Salvador, Brazil
²Department of Ophthalmology, Faculdade de Medicina da Bahia, Salvador, Brazil

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A patient in their early 50s with diagnosed myopia presented with pathological signs on fundus examination (ie, diffuse retinal pigment epithelial attenuation, retinal atrophy, and posterior staphyloma), for which they underwent complete imaging workup. Fundus photography permitted the visualization of an unusual insertion of a short posterior ciliary artery (SPCA), which is imperceptible in normal eyes (Figure). SPCAs are branches of the ophthalmic artery as it crosses the optic nerve. These vessels enter the eye perpendicularly through the sclera and feed the choriocapillaris lobules. SPCAs may also emerge in the macular region.¹ In highly myopic eyes, on the other hand, their entry sites into the choroid may be displaced to the midperiphery close to the edge of a posterior staphyloma.² There is a possibility that myopic choroidal neovascularization could originate from deeply situated scleral vessels³ such as SCPAs.

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Article Information

Corresponding Author: Giovanna Vieira Moreira, MD, Department of Ophthalmology, Clínica de Olhos Leitão Guerra, Cícero Simões St, No. 119, Apt 301, Salvador 41830-476, Brazil (giovieiramoreira@gmail.com).

Conflict of Interest Disclosures: None reported.

References

Haug S , Fu AD , Johnson RNH , et al. Fluorescein angiography: basic principles and interpretation. In: Wilkinson CP , Hinton DR , Sadda SR , Wiedemann P , eds. Ryan’s Retina. 6th ed. Elsevier; 2017:163-258.

Moriyama M , Ohno-Matsui K , Futagami S , et al. Morphology and long-term changes of choroidal vascular structure in highly myopic eyes with and without posterior staphyloma. Ophthalmology. 2007;114(9):1755-1762. doi:10.1016/j.ophtha.2006.11.034 PubMed Google Scholar Crossref

Ishida T , Watanabe T , Yokoi T , Shinohara K , Ohno-Matsui K . Possible connection of short posterior ciliary arteries to choroidal neovascularisations in eyes with pathologic myopia. Br J Ophthalmol. 2019;103(4):457-462. doi:10.1136/bjophthalmol-2018-312015 PubMed Google Scholar Crossref

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 credit toward the CME of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.