Ocular late effects in childhood and adolescent cancer survivors: a report from the childhood cancer survivor study.

Academic Article

Abstract

  • INTRODUCTION: Approximately 80% of children currently survive 5 years following diagnosis of their cancer. Studies based on limited data have implicated certain cancer therapies in the development of ocular sequelae in these survivors. PROCEDURE: The Childhood Cancer Survivor Study (CCSS) is a retrospective cohort study investigating health outcomes of 5+ year survivors diagnosed and treated between 1970 and 1986 compared to a sibling cohort. The baseline questionnaire included questions about the first occurrence of six ocular conditions. Relative risks (RR) and 95% confidence intervals (CI) were calculated from responses of 14,362 survivors and 3,901 siblings. RESULTS: Five or more years from the diagnosis, survivors were at increased risk of cataracts (RR: 10.8; 95% CI: 6.2-18.9), glaucoma (RR: 2.5; 95% CI: 1.1-5.7), legal blindness (RR: 2.6; 95% CI: 1.7-4.0), double vision (RR: 4.1; 95% CI: 2.7-6.1), and dry eyes (RR: 1.9; 95% CI: 1.6-2.4), when compared to siblings. Dose of radiation to the eye was significantly associated with risk of cataracts, legal blindness, double vision, and dry eyes, in a dose-dependent manner. Risk of cataracts were also associated with radiation 3,000+ cGy to the posterior fossa (RR: 8.4; 95% CI: 5.0-14.3), temporal lobe (RR: 9.4; 95% CI: 5.6-15.6), and exposure to prednisone (RR: 2.3; 95% CI: 1.6-3.4). CONCLUSIONS: Childhood cancer survivors are at risk of developing late occurring ocular complications, with exposure to glucocorticoids and cranial radiation being important determinants of increased risk. Long-term follow-up is needed to evaluate potential progression of ocular deficits and impact on quality of life.
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    Keywords

  • Adolescent, Adult, Child, Child, Preschool, Eye, Eye Diseases, Female, Glucocorticoids, Humans, Infant, Infant, Newborn, Male, Middle Aged, Neoplasms, Neoplasms, Radiation-Induced, Prognosis, Radiation Injuries, Retrospective Studies, Surveys and Questionnaires, Survival Rate, Survivors, Young Adult
  • Digital Object Identifier (doi)

    Author List

  • Whelan KF; Stratton K; Kawashima T; Waterbor JW; Castleberry RP; Stovall M; Sklar CA; Packer RJ; Mitby P; Aitken CL
  • Start Page

  • 103
  • End Page

  • 109
  • Volume

  • 54
  • Issue

  • 1