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Cancer. 2016 Mar 1;122(5):730-9. doi: 10.1002/cncr.29705. Epub 2016 Jan 11.

Impact of vision loss among survivors of childhood central nervous system astroglial tumors.

Author information

  • 1Division of Pediatric Hematology and Oncology, Rainbow Babies & Children's Hospital, Cleveland, Ohio.
  • 2Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio.
  • 3Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
  • 4Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
  • 5Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.
  • 6Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, Washington.
  • 7Department of Pediatrics, Memorial Sloan Kettering Cancer Center/Weill Cornell Medical College, New York, New York.
  • 8Division of Radiation Oncology, Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas.

Abstract

BACKGROUND:

The impact of impaired vision on cognitive and psychosocial outcomes among long-term survivors of childhood low-grade gliomas has not been investigated previously but could inform therapeutic decision making.

METHODS:

Data from the Childhood Cancer Survivor Study were used to investigate psychological outcomes (measures of cognitive/emotional function) and socioeconomic outcomes (education, income, employment, marital status, and independent living) among astroglial tumor survivors grouped by 1) vision without impairment, 2) vision with impairment (including unilateral blindness, visual field deficits, and amblyopia), or 3) bilateral blindness. The effect of vision status on outcomes was examined with multivariate logistic regression with adjustments for age, sex, cranial radiation therapy, and medical comorbidities.

RESULTS:

Among 1233 survivors of childhood astroglial tumors 5 or more years after their diagnosis, 277 (22.5%) had visual impairment. In a multivariate analysis, survivors with bilateral blindness were more likely to be unmarried (adjusted odds ratio (OR), 4.7; 95% confidence interval [CI], 1.5-15.0), live with a caregiver (adjusted OR, 3.1; 95% CI, 1.3-7.5), and be unemployed (adjusted OR, 2.2; 95% CI, 1.1-4.5) in comparison with those without visual impairment. Bilateral blindness had no measurable effect on cognitive or emotional outcomes, and vision with impairment was not significantly associated with any psychological or socioeconomic outcomes.

CONCLUSIONS:

Adult survivors of childhood astroglial tumors with bilateral blindness were more likely to live unmarried and dependently and to be unemployed. Survivors with visual impairment but some remaining vision did not differ significantly with respect to psychological function and socioeconomic status from those without visual impairment. Cancer 2016;122:730-739. © 2016 American Cancer Society.

KEYWORDS:

childhood cancer survivors; optic pathway glioma; pediatric glioma late effects; vision loss

PMID:
26755438
PMCID:
PMC4764436
[Available on 2017-03-01]
DOI:
10.1002/cncr.29705
[PubMed - indexed for MEDLINE]
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