Premium
Impact of vision loss among survivors of childhood central nervous system astroglial tumors
Author(s) -
de Blank Peter M. K.,
Fisher Michael J.,
Lu Lu,
Leisenring Wendy M.,
Ness Kirsten K.,
Sklar Charles A.,
Stovall Marilyn,
Vukadinovich Chris,
Robison Leslie L.,
Armstrong Gregory T.,
Krull Kevin R.
Publication year - 2016
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.29705
Subject(s) - psychosocial , medicine , socioeconomic status , visual impairment , odds ratio , marital status , confidence interval , cognition , multivariate analysis , visual acuity , logistic regression , pediatrics , psychiatry , population , surgery , environmental health
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 .