Vasculature and morphometry of the optic canal and intracanalicular optic nerve.

OBJECTIVES

To study the bony structure of the optic canal and the vasculature of the intracanalicular optic nerve in human cadavers.

MATERIALS AND METHODS

Gross and microscopic examinations were performed in 25 optic canals from 13 cadavers to study the pattern of vascular supply of the intracanalicular optic nerve. Neoprene latex was injected through the most proximal part of the ophthalmic artery in seven optic canals. The intracanalicular branches from the ophthalmic artery were carefully identified and quantified. Quantitative measurements of the canal length, canal thickness, canal transverse area, optic nerve transverse area, and subdural space were done for the other 18 canals by means of semiautomated morphometric analysis system. Each canal was divided into anterior, middle, and posterior parts for better visualization and measurement.

RESULTS

The ophthalmic artery gives off three branches that supply the intracanalicular optic nerve: medial collateral branch, lateral collateral branch, and ventral branch. Each branch pierces the dura and then supplies the nerve through the pia mater. The middle medial wall was the thinnest bony part of the canal (0.31 +/- 0.06 mm). The optic canal, optic nerve, and subdural space transverse area varied at different transection levels. The narrowest space was in the middle part of the optic canal. The mean subdural cross-sectional space was only 1.84 mm2. This, multiplied by the average canal length (11.79 mm), can be considered the potential space for hemorrhage, optic nerve edema, or hematoma.

CONCLUSIONS

The vasculature within the bony canal is extremely delicate. Due to the limitation of this space, even a tiny amount of blood or swelling of the nerve (21.69 mm3) may cause optic nerve compression. It appears that these vessels could easily be disrupted in closed head injury by a shearing or concussive force, leading to ischemic infarction of the optic nerve. Since the narrowest portion of the canal is in the middle portion, it is the middle part of the optic canal that is most critical in doing an optic canal decompression.