Ophthalmic evaluation of survivors of acute lymphoblastic leukemia

Eighty-two survivors of acute lymphoblastic leukemia (ALL) had prospective eye evaluations to determine the ocular sequelae of the disease and its treatment. All patients had completed or nearly completed a 25- to 31-month protocol which included either 3.4 or 10.2 g of systemic prednisone/m2 per year and cranial irradiation (total 1800-2800 rad). The mean interval from the end of treatment to the eye examination was 32 months. Only one patient had reduced vision attributable to the ALL. Ocular morbidity attributed to the treatment only included posterior subcapsular cataracts (PSCs) which occurred in 52% of patients. Posterior subcapsular cataracts (PSCs) developed in none of the 15 survivors of acute myelogenous leukemia (AML) examined who had received neither long-term systemic prednisone nor irradiation (P = 0.0006). Eyes with PSC had a median visual acuity of 20/20 (range, 20/15-20/50). The authors conclude that the ocular morbidity from antileukemia treatment programs at our institutions is minimal.