Cancer therapies linked to risk for late ocular complications in pediatric survivors

Childhood cancer survivors face a high risk of ocular complications, particularly cataract, after exposure to glucocorticoids and cranial radiation, a study showed.

Study participants were taken from the Childhood Cancer Survivor Study, a retrospective cohort study of health outcomes of cancer patients surviving five years or more from diagnosis between 1970 and 1986. Outcomes of the 14,362 cancer survivors were compared with outcomes for 3,901 siblings.

A baseline questionnaire was designed to record the first occurrence of six possible ocular complications after cancer treatment. Relative risk scores for ocular complications were calculated based on survey data.

At five years or longer after diagnosis, cancer survivors had a 10.8 RR of cataracts, a 2.5 RR of glaucoma, a 2.6 RR of legal blindness, a 4.1 RR of double vision and a 1.9 RR of dry eyes compared to siblings. Risk for cataracts, legal blindness, double vision and dry eyes had a dose-dependent association with radiation.

Radiation of more than 3,000 cGy to the posterior fossa was associated with an 8.4 RR of cataract, and the same level of radiation applied to the temporal lobe had a 9.4 RR of cataract. Exposure to prednisone had a 2.3 RR of cataract.

Whelan KF. Pediatr Blood Cancer. 2010;54:103-109.