OCULAR SEQUELAE OF MULTIMODAL THERAPY OF HEMATOLOGIC MALIGNANCIES IN CHILDREN

We retrospectively analyzed the ocular findings after polychemotherapy including intrathecal methotrexate, systemic corticosteroids, and pro phylactic cranial irradiation in children with acute lymphoblastic leu kemia (n = 16) and non-Hodgkin's lymphoma (n = 2). After a median surv eillance time of 4.1 years, asymptomatic ocular abnormalities were obs erved in 83% of the patients: 7/18 had a decreased tear formation, 5/1 7 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 techniqu es (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 vitreo us body were caused by thrombopenia and bleeding during the course of disease, corticoid therapy might have contributed to the lens opacitie s. (C) 1994 Wiley-Liss, Inc.