Corticosteroid-Induced Ocular Hypertension in Children and Adolescents With Acute Lymphocytic Leukemia and Non-Hodgkin Lymphoma: A Systematic Review

Abstract

Objective: Conduct a systematic review to assess the risk of increased intraocular pressure (IOP) associated with corticosteroid use in children and adolescents with acute lymphocytic leukemia (ALL) and non-Hodgkin's lymphoma (NHL). Methodology: A search was performed on PubMed, Scopus, Web of Science, Science Direct Cochrane Library, Google Scholar and OpenThesis databases. Relevant studies were read in full and selected according to eligibility criteria (children and adolescents up to 19 years of age with ALL or NHL, regardless of gender, and who were treated with systemic corticosteroids regularly) and those who reported ocular hypertension due to tumor infiltration, and glaucomatous damage and corticosteroid-induced ocular hypertension in initial testing. Results: 8 studies were selected: three case reports, a series of 5 cases, two prospective observational studies -one with 55 patients and one with 90 patientsand two retrospective observational studies -one with 54 and one with 12 patients. The results demonstrated eventual control of IOP, and consequences ranging from no ocular impairment to complete loss of vision.Conclusion: The possibility of silent ocular hypertension, with risk of irreversible amaurosis, demonstrates the need to evaluate the introduction of an evaluation and treatment protocol in pediatric patients soon after the diagnosis of ALL or NHL. However, given the limited evidence, further studies are warranted evaluating IOP and visual function before treatment initiation, as well as systematic measures during and after treatment.