Abstract
Purpose: :
To evaluate the ocular hypertensive response to repetitive cycles of high-dose systemic corticosteroid in young patients with acute lymphoblastic leukemia (ALL).
Methods: :
Five patients up to 6 years of age with ALL who received chemotherapy between November 2003 and March 2005 were examined. They received oral or intravenous prednisolone (60 mg/m2/day) for 4 weeks during remission induction therapy and then dexamethasone (12 mg/m2/day) for 2 weeks, followed by 1-week tapering and 5-week break during maintenance phase (15 cycles). Comprehensive ophthalmic check-up, including best-corrected visual acuity, intraocular pressure (IOP), and slit-lamp and fundus examinations, were performed.
Results: :
All patients were followed up until final cycle. IOP >21 mmHg was observed in all patients. IOP increased to a maximum of mean 40.6±9.0 (range 28-53) mmHg. The range of cycle to reach a maximal IOP was 2 to 11. All patients were maintained IOP control with antiglaucoma medications. However, one patient had severe glaucomatous optic atrophy.
Conclusions: :
Systemic corticosteroid in childhood-ALL treatment frequently causes severe IOP rise. Periodical and careful ophthalmic check-up is necessary.
Keywords: corticosteroids • drug toxicity/drug effects • intraocular pressure