Glaucoma cortisônico em crianças e adolescentes com leucemia linfóide aguda: proposta de um protocolo para identificação e tratamento precoce

Abstract

Objective: To identify changes in intraocular pressure (IOP) and other ophthalmic damage in pediatric patients undergoing treatment for acute lymphoid leukemia (ALL). Methods: A prospective, descriptive study were conducted with children and adolescents with ALL registered for starting chemotherapy in a public service specialized in pediatric oncology localized in the northeastern region of Brazil between July 1, 2013 and December 30, 2017. Intraocular pressure (IOP) was measured before treatment (D0), eighth (D8), twenty-eighth (D28) days and six months (6M) treatment. IOP results above 21 mmHg were considered ocular hypertension. During the six months follow-up the patients were evaluated for identification of other ophthalmological changes besides intraocular hypertension. Results and conclusions: Fifty-eight patients were evaluated and 23 (39,6%) died during treatment. Two protocols were used, the LLA-99, proposed in 1999 (29 patients) and the update of this in 2009, the LLA-09 (29 patients). From those 58 patients, 11 (19,0%) had IOP values higher than 21 mmHg. The total amount of patients with a direct or indirect ocular involvement was 17 (29,3%). Ophthalmologic evaluation with IOP measurement prior to initiation of treatment and repeated at eight and 28 days and six months of treatment may allow early diagnosis of IOP increasing and other ophthalmologic damage at those patients.