Gamma knife radiosurgery in neuro-ophthalmology.

PURPOSE OF REVIEW: Following technological advances in imaging and dose planning made in the past decade, gamma knife radiosurgery has become more and more an established treatment for a wide range of indications of interest and import to the neuro-ophthalmology community. These areas include cavernous sinus lesions and sellar lesions (for which radiosurgery can be offered as adjuvant or in certain cases as primary treatment), cavernous sinus fistulae, parasellar syndromes, and pituitary tumors.

RECENT FINDINGS: Occurrence of radiation-induced cranial nerve deficits and radiation-induced optic neuropathy are infrequent following radiosurgery to these areas, and perhaps radiation-induced necrosis is less prevalent than in conventional radio therapeutic interventions.

SUMMARY: Gamma knife radiosurgery remains a compelling treatment for lesions of the cavernous sinus, pineal, and sellar regions and offers increasing applicability for ocular conditions such as uveal melanoma and glaucoma.