Faculty Collaboration Database

Ocular late effects in childhood and adolescent cancer survivors: a report from the childhood cancer survivor study. Pediatr Blood Cancer 2010 Jan;54(1):103-9

Date

09/24/2009

Pubmed ID

19774634

Pubmed Central ID

PMC2783513

DOI

10.1002/pbc.22277

Scopus ID

2-s2.0-73349130796 (requires institutional sign-in at Scopus site)   76 Citations

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.

Author List

Whelan KF, Stratton K, Kawashima T, Waterbor JW, Castleberry RP, Stovall M, Sklar CA, Packer RJ, Mitby P, Aitken CL, Blatt J, Robison LL, Mertens AC

Author

Candice A. Johnstone MD, MPH Professor in the Radiation Oncology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

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