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Br J Ophthalmol 1999;83:1324-1328 ( December )

Ocular arterial blood flow of choroidal melanoma eyes before and after stereotactic radiotherapy using Leksell gamma knife: 2 year follow up

Pia V Vécsei, Karl Kircher, Gunda Nagel, Sabine Toma-Bstaendig, Irene Ruhswurm, Michael Georgopoulos, Martin Zehetmayer

Department of Ophthalmology, University of Vienna Medical School, Vienna, Austria

Correspondence to: Pia V Vécsei, Department of Ophthalmology, University of Vienna Medical School, Waehringer Guertel 18-20, A 1090 Vienna, Austria

Accepted for publication 29 June 1999

AIMS---To evaluate the effect of high dose stereotactic radiotherapy on the ocular blood flow of patients with uveal melanoma.
METHODS---Colour Doppler imaging (CDI) was used to measure blood flow velocity and vascular resistance in the ophthalmic, short posterior, and central retinal arteries of nine patients suffering from uveal melanoma. The measurements were taken before, 6 months, 1 year, and 2 years after stereotactic radiotherapy. Irradiation was performed with the Leksell gamma knife with the 59 (41-66.5) Gy total marginal dose divided in two equal fractions. CDI results were compared with age and sex matched healthy control eyes.
RESULTS---At each time of measurement, blood flow velocity in the central retinal artery of the affected eyes was significantly reduced whereas vascular resistance was only increased at the 2 year follow up. Blood flow velocity and vascular resistance in the short posterior arteries of melanoma eyes were also only significantly altered at the 2 year follow up. Blood flow velocity and vascular resistance in the ophthalmic artery of melanoma eyes were not changed at all follow ups.
CONCLUSIONS---In the melanoma eyes, blood flow velocity in the central retinal artery is reduced. High dose stereotactic radiotherapy with the Leksell gamma knife and a 59 (41-66.5) Gy total marginal dose in two fractions leads to a significant reduction of blood flow and a significant increase in resistance variables in the small ocular arteries within 2 years.

© 1999 by British Journal of Ophthalmology


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