Ocular sequelae of multimodal therapy of hematologic malignancies in children

Med Pediatr Oncol. 1994;23(4):344-9. doi: 10.1002/mpo.2950230405.

Abstract

We retrospectively analyzed the ocular findings after polychemotherapy including intrathecal methotrexate, systemic corticosteroids, and prophylactic cranial irradiation in children with acute lymphoblastic leukemia (n = 16) and non-Hodgkin's lymphoma (n = 2). After a median surveillance time of 4.1 years, asymptomatic ocular abnormalities were observed in 83% of the patients: 7/18 had a decreased tear formation, 5/17 had an opacity of the vitreous body, and 13/18 had an opacity of the lens. It was not possible to determine retrospectively which therapy caused a particular effect. A comparison of the 2 irradiation techniques (with and without blocking of the lacrimal glands) showed that in 5/7 children who developed a reduced eye secretion, the lacrimal glands are within the treatment volume. Therefore, the reduced eye secretion is most likely radiation-induced. Whereas the opacities of the vitreous body were caused by thrombopenia and bleeding during the course of disease, corticoid therapy might have contributed to the lens opacities.

MeSH terms

  • Adolescent
  • Antineoplastic Agents / adverse effects*
  • Cataract / etiology
  • Child
  • Child, Preschool
  • Combined Modality Therapy / adverse effects
  • Cranial Irradiation / adverse effects*
  • Eye Diseases / etiology*
  • Female
  • Glucocorticoids / adverse effects
  • Humans
  • Lymphoma, Non-Hodgkin / therapy*
  • Male
  • Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy*
  • Retrospective Studies
  • Vision Disorders / etiology

Substances

  • Antineoplastic Agents
  • Glucocorticoids