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

Aims-To evaluate the effect of high dose stereotactic radiotherapy on the o cular blood flow of patients with uveal melanoma. Methods-Colour Doppler imaging (CDI) was used to measure blood flow velocit y and vascular resistance in the ophthalmic, short posterior, and central r etinal arteries of nine patients suffering from uveal melanoma. The measure ments were taken before, 6 months, 1 year, and 2 years after stereotactic r adiotherapy Irradiation was performed with the Leksell gamma knife with the 59 (41-66.5) Gy total marginal dose divided in two equal fractions. CDI re sults were compared with age and sex matched healthy control eyes. Results-At each time of measurement, blood flow velocity in the central ret inal 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 w ere also only significantly altered at the 2 year follow up. Blood flow vel ocity and vascular resistance in the ophthalmic artery of melanoma eyes wer e not changed at all follow ups. Conclusions-In the melanoma eyes, blood flow velocity in the central retina l artery is reduced. High dose stereotactic radiotherapy with the Leksell g amma 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 res istance variables in the small ocular arteries within 2 years.