Alterações oftalmológicas em pacientes pediátricos tratados para leucemia linfoblástica aguda e linfoma NÃO-HODGKIN

Abstract

Acute lymphoblastic leukemia (ALL) is the most common cancer diagnosed in children between 0 and 14 and corresponds to 78% of leukemias in this age group. Non- Hodgkin's lymphoma (NHL) affects approximately 4% of children and adolescents with cancer, with a progressive increase in incidence with age. Despite the successful chemotherapy treatment for ALL and NHL, several studies point to late changes in various organs and systems, including possible eye complications such as the induction of ocular hypertension and iatrogenic glaucoma by the use of glucocorticoids (GC). The aim of this study was to evaluate the presence of visual impairment in children with ALL and NHL during the treatment of these diseases. Were included in the study: patients with diagnosis of ALL or NHL by immunophenotyping of bone marrow or peripheral blood sample (ALL), or immunohistochemistry of material obtained through open biopsy (NHL); age below 19 years; absence of previous chemotherapy treatment; absence of prior diagnosis compatible with glaucoma or previous disease related to any change in intraocular pressure (IOP); no use of systemic GC in the six months preceding the diagnosis of ALL or NHL. Along children and adolescents evaluation, ocular or other changes were noticed. It has been shown that, in steroid-induced glaucoma, IOP elevation is gradual and, as in the open-angle glaucoma, there is little symptomatology. In this study, none of the patients with IOP increased showed symptoms of ocular hypertension, also demonstrated in previous studies, which makes it difficult to diagnose without an ophthalmologic evaluation.