The risk of posterior subcapsular cataracts in granulocyte donors

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.

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).

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).

This study does not support the hypothesis that corticosteroid stimulation of PMN donors is associated with an increased risk of developing a PSC.