The risk of posterior subcapsular cataracts in granulocyte donors.
BACKGROUND
Therapeutic use of adrenal corticosteroids is a risk factor for the development of posterior subcapsular cataract (PSC). Because corticosteroids are given to donors of apheresis granulocytes (PMNs) to improve yield, this study was performed to determine the prevalence of PSCs in PMN donors relative to a matched control group of apheresis platelet (PLT) donors.


METHODS
This study was a cross-sectional study stratified by age, sex, and lifetime apheresis experience at three sites. Individuals who had made at least five PMN donations preceded by corticosteroids were eligible. The presence of PSC was ascertained by grading digital retroillumination images of both lenses. A random subset of participants underwent clinical eye examinations by ophthalmologists masked as to study group. A logistic regression model was used to compute odds ratios (ORs).


RESULTS
Granulocyte donors had given a mean of 13 donations (range, 5-39 donations) over a mean period of 8.5 years (range, 0.3-25.2 years). The mean corticosteroid exposure, in cortisol equivalents, was 2840 mg (range, 1067-9040 mg). Six of 89 PMN donors had photographic evidence of PSCs versus 4 of 89 controls. This difference was not significant (OR, 1.54; 95% confidence interval [CI], 0.46-5.08). Five of 33 PMN donors and 3 of 30 PLT donors had evidence of PSC by clinical examination. This difference was also not significant (OR, 1.61; 95% CI, 0.35-7.39).


CONCLUSIONS
This study does not support the hypothesis that corticosteroid stimulation of PMN donors is associated with an increased risk of developing a PSC.
Burch
John W
JW
American Red Cross Blood Services, New York-Penn Region, West Henrietta, 14586, USA. burchj@usa.redcross.org
Mair
David C
DC
Meny
Geralyn M
GM
Moroff
Gary
G
Ching
Steven S T
SS
Naidoff
Michael A
MA
Steuer
Eric R
ER
Loftus
Sanaz A
SA
Armstrong
Jane
J
Clemons
Traci E
TE
Klein
Barbara E K
BE
D000305:Adrenal Cortex Hormones / Q000009:adverse effects* / Q000494:pharmacology; D000328:Adult; D000368:Aged; D001781:Blood Component Removal; D001782:Blood Donors; D001792:Blood Platelets; D002386:Cataract / Q000139:chemically induced* / Q000453:epidemiology / Q000473:pathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D015995:Prevalence; D018570:Risk Assessment
D000305:Adrenal Cortex Hormones