Chang Yitian, Zhang YuTong, Cui Zhihua, Jin Xianmei, Zhao Yufei, Liang Lingling, Chang Jian
Department of Ophthalmology, The Second Hospital of Dalian Medical University, Dalian, China.
Department of Pediatric Oncology, The First Hospital of Jilin University, Changchun, China.
Front Pediatr. 2022 Aug 12;10:982224. doi: 10.3389/fped.2022.982224. eCollection 2022.
To investigate the effect of systemic corticosteroids (CSs) on ocular hypertension (OHT) and to evaluate the management of OHT in children with non-Hodgkin lymphoma (NHL).
Medical records of children with NHL treated in our institution between October 2016 and October 2019 were reviewed. The enrolled patients were divided into the mature B-cell lymphoma (MBL) group and lymphoblastic lymphoma (LBL) group based on pathology. Data on routine ophthalmic examinations and management of OHT were recorded.
Of the 54 recruited patients, 38 patients (70.4%) had LBL, and 16 (29.6%) had MBL. Thirty-one patients (57.4%) developed OHT, 24 patients (77.4%) in the LBL group, and 7 (22.6%) in the MBL group. Twelve patients (38.7%) were identified as high responders (10 with LBL and 2 with MBL). Symptomatic patients had a higher mean peak IOP than asymptomatic patients (=0.006). A total of 74.2% of OHT was controlled with antiglaucoma medications (100% in the MBL group . 66.7% in the LBL group, significant variation, < 0.001). In total, 8 patients (25.8%) underwent tapering of the CSs dose. The duration of OHT was shorter in the MBL group than in the LBL group ( = 0.003). No patients were found to have glaucomatous damage or cataracts.
Patients receiving systemic CSs had a higher risk of developing OHT, but the pattern of CSs administration might be a critical factor in the risk and severity of OHT. Tapering of CSs dose should be considered the first line for the management of OHT during high-dose CSs therapy.
探讨全身用糖皮质激素（CSs）对高眼压（OHT）的影响，并评估非霍奇金淋巴瘤（NHL）患儿高眼压的治疗。
回顾2016年10月至2019年10月在本机构接受治疗的NHL患儿的病历。根据病理将入选患者分为成熟B细胞淋巴瘤（MBL）组和淋巴细胞淋巴瘤（LBL）组。记录常规眼科检查数据和高眼压的治疗情况。
在54例入选患者中，38例（70.4%）为LBL，16例（29.6%）为MBL。31例（57.4%）发生高眼压，LBL组24例（77.4%），MBL组7例（22.6%）。12例（38.7%）被确定为高反应者（10例LBL，2例MBL）。有症状患者的平均眼压峰值高于无症状患者（=0.006）。74.2%的高眼压通过抗青光眼药物得到控制（MBL组为100%，LBL组为66.7%，差异有统计学意义，<0.001）。共有8例（25.8%）患者接受了CSs剂量的逐渐减量。MBL组高眼压持续时间短于LBL组（=0.003）。未发现患者有青光眼性损害或白内障。
接受全身用CSs治疗的患者发生高眼压的风险较高，但CSs的给药方式可能是高眼压风险和严重程度的关键因素。在大剂量CSs治疗期间，CSs剂量逐渐减量应被视为高眼压治疗的一线方法。
