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

Peter M.K. De Blank, Michael J. Fisher, Lu Lu, Wendy M. Leisenring, Kirsten K. Ness, Charles A. Sklar, Marilyn Stovall, Chris Vukadinovich, Leslie L. Robison, Gregory Armstrong, Kevin R. Krull

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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.

Original languageEnglish (US)
Pages (from-to)730-739
Number of pages10
JournalCancer
Volume122
Issue number5
DOIs
StatePublished - Mar 1 2016
Externally publishedYes

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Central Nervous System Neoplasms
Survivors
Blindness
Vision Disorders
Odds Ratio
Confidence Intervals
Psychology
Neoplasms
Independent Living
Amblyopia
Marital Status
Visual Fields
Social Class
Glioma
Cognition
Caregivers
Comorbidity
Decision Making
Radiotherapy
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

De Blank, P. M. K., Fisher, M. J., Lu, L., Leisenring, W. M., Ness, K. K., Sklar, C. A., ... Krull, K. R. (2016). Impact of vision loss among survivors of childhood central nervous system astroglial tumors. Cancer, 122(5), 730-739. https://doi.org/10.1002/cncr.29705

Impact of vision loss among survivors of childhood central nervous system astroglial tumors. / 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; Krull, Kevin R.

In: Cancer, Vol. 122, No. 5, 01.03.2016, p. 730-739.

Research output: Contribution to journalArticle

De Blank, PMK, Fisher, MJ, Lu, L, Leisenring, WM, Ness, KK, Sklar, CA, Stovall, M, Vukadinovich, C, Robison, LL, Armstrong, G & Krull, KR 2016, 'Impact of vision loss among survivors of childhood central nervous system astroglial tumors', Cancer, vol. 122, no. 5, pp. 730-739. https://doi.org/10.1002/cncr.29705
De Blank PMK, Fisher MJ, Lu L, Leisenring WM, Ness KK, Sklar CA et al. Impact of vision loss among survivors of childhood central nervous system astroglial tumors. Cancer. 2016 Mar 1;122(5):730-739. https://doi.org/10.1002/cncr.29705
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 ; Krull, Kevin R. / Impact of vision loss among survivors of childhood central nervous system astroglial tumors. In: Cancer. 2016 ; Vol. 122, No. 5. pp. 730-739.
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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.",
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AU - De Blank, Peter M.K.

AU - Fisher, Michael J.

AU - Lu, Lu

AU - Leisenring, Wendy M.

AU - Ness, Kirsten K.

AU - Sklar, Charles A.

AU - Stovall, Marilyn

AU - Vukadinovich, Chris

AU - Robison, Leslie L.

AU - Armstrong, Gregory

AU - Krull, Kevin R.

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N2 - 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.

AB - 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.

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