Elevated intraocular pressure in children with acute lymphoblastic leukaemia: A prospective study
| Autor: | Shai Izraeli, Sarah Elitzur, Shlomit Barzilai-Birenboim, Miriam Ehrenberg, Noa Geffen, Ronit Nirel, Alon Zahavi, Gil Gilad, Rabeea Haj Daood, Gad Dotan, Itay E. Gabbay, Galia Avrahami |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Intraocular pressure genetic structures Adolescent Antineoplastic Agents Hormonal Ocular hypertension Logistic regression Dexamethasone Body Mass Index Elevated intraocular pressure Risk Factors medicine Humans Prospective Studies Risk factor Prospective cohort study Child Glucocorticoids Intraocular Pressure business.industry Infant Hematology Precursor Cell Lymphoblastic Leukemia-Lymphoma medicine.disease eye diseases Child Preschool Lymphoblastic leukaemia Female Ocular Hypertension sense organs business medicine.drug |
| Zdroj: | British journal of haematologyReferences. 196(5) |
| ISSN: | 1365-2141 |
| Popis: | Most childhood acute lymphoblastic leukaemia (ALL) protocols include high-dose steroid therapy. However, the known potential of high-dose steroids to significantly elevate intraocular pressure (IOP) and lead to glaucomatous optic neuropathy has not been intensively investigated in children with ALL. Moreover, as children with ALL do not routinely undergo IOP measurements, the need for IOP monitoring and therapy is unknown. We prospectively measured IOP in 90 children with newly diagnosed ALL attending a tertiary paediatric haematology/oncology centre, at diagnosis and at the middle and end of induction therapy. Ocular hypertension (IOP > 21 mm Hg) at any time point was documented in 64 children (71%), and the prevalence increased during induction. Thirty-six children (40%) had elevated IOP at ALL diagnosis before therapy initiation, and stratification to non-standard ALL was a risk factor. IOP reduction therapy was administered to 13 children (14%); none required surgery. Values normalised in all cases. On multivariate logistic regression analysis, dexamethasone therapy was a significant risk factor for ocular hypertension. High body mass index was an additional risk factor in children with elevated IOP at ALL diagnosis. Routine evaluation of IOP during steroid therapy is very important in children with ALL to ensure early intervention which may prevent permanent ocular damage. |
| Databáze: | OpenAIRE |
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