Other investigators and institutions participating in the Childhood Cancer Survivor Study are listed in the Supplemental Appendix.
Ocular late effects in childhood and adolescent cancer survivors: A report from the childhood cancer survivor study†
Article first published online: 22 SEP 2009
Copyright © 2009 Wiley-Liss, Inc.
Pediatric Blood & Cancer
Volume 54, Issue 1, pages 103–109, January 2010
How to Cite
Whelan, K. F., Stratton, K., Kawashima, T., Waterbor, J. W., Castleberry, R. P., Stovall, M., Sklar, C. A., Packer, R. J., Mitby, P., Aitken, C. L., Blatt, J., Robison, L. L. and Mertens, A. C. (2010), Ocular late effects in childhood and adolescent cancer survivors: A report from the childhood cancer survivor study. Pediatr. Blood Cancer, 54: 103–109. doi: 10.1002/pbc.22277
- Issue published online: 9 NOV 2009
- Article first published online: 22 SEP 2009
- Manuscript Accepted: 11 AUG 2009
- Manuscript Received: 26 MAY 2009
- National Cancer Institute. Grant Number: U24 CA55727
- Children's Cancer Research Fund, Minneapolis, MN
- American Lebanese Syrian Associated Charities (ALSAC)
- late effects of cancer therapy;
- radiation therapy
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.
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.
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).
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. Pediatr Blood Cancer 2010; 54:103–109. © 2009 Wiley-Liss, Inc.