title: Ocular sequelae of multimodal therapy of hematologic malignancies in children.
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.
authors.affiliation: Department of Radiotherapy, University of Graz, Austria.
authors.forename: B
authors.initials: B
authors.lastname: Pakisch
authors.forename: G
authors.initials: G
authors.lastname: Langmann
authors.forename: A
authors.initials: A
authors.lastname: Langmann
authors.forename: I
authors.initials: I
authors.lastname: Slavc
authors.forename: E
authors.initials: E
authors.lastname: Poier
authors.forename: C
authors.initials: C
authors.lastname: Urban
authors.forename: J
authors.initials: J
authors.lastname: Poschauko
authors.forename: H
authors.initials: H
authors.lastname: Lackner
authors.forename: S
authors.initials: S
authors.lastname: Knoblauch
authors.forename: H
authors.initials: H
authors.lastname: Leitner
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002386:Cataract / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy / Q000009:adverse effects; D016371:Cranial Irradiation / Q000009:adverse effects*; D005128:Eye Diseases / Q000209:etiology*; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000628:therapy*; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy*; D012189:Retrospective Studies; D014786:Vision Disorders / Q000209:etiology
chemical_list: D000970:Antineoplastic Agents; D005938:Glucocorticoids