Prevalence of Posterior Subcapsular Cataracts in Volunteer Cytapheresis Donors
Year of Publication
Clayton, J; Vitale, S; Kim, J; Conry-Cantilena, C; Byrne, P; Reed, G; Ferris, FL 3rd; Leitman, S
Aged; Cataract/epidemiology; Cytapheresis/methods; Cytapheresis/statistics & numerical data; Dexamethasone/adverse effects; Female; Glucocorticoids/adverse effects; Granulocytes/transplantation; Humans; Logistic Models; Male; Middle Aged; Multivariate An
BACKGROUND: Granulocyte donors routinely receive dexamethasone orally before donation. Steroids may increase the risk of posterior subcapsular cataract (PSC) formation. STUDY DESIGN AND METHODS: We recruited 100 granulocyte donors (four or more granulocyte donations; any number of platelet [PLT] donations) and 100 age- and sex-matched PLT donors (zero to three granulocyte donations, any number of PLT donations) to examine the risk of PSC. PSC was assessed by a masked ophthalmologist and reading center lens photograph gradings or medical record documentation of PSC as the reason for cataract extraction. RESULTS: Fourteen eyes of 10 granulocyte donors and five eyes of four PLT donors had PSCs (odds ratio [OR], 2.82; 95% confidence interval [CI], 0.83-9.61; p=0.10). Risk of PSC increased with number of granulocyte donations: compared to zero to three donations (4.0%), the risk for four to nine, 10 to 19, and 20 or more donations was 8.6% (OR, 2.25; 95% CI, 0.31-13.99; p=0.30), 9.5% (OR, 2.53; 95% CI, 0.44-14.20; p=0.21), and 13.0% (OR, 3.60; 95% CI, 0.48-22.81; p=0.11), respectively (p=0.06 for trend). CONCLUSION: We did not demonstrate a statistically significant increased risk of PSC associated with granulocyte donation. However, although this makes a large risk unlikely, we cannot rule out a small to moderate risk and there is biologic plausibility that the steroid administration associated with granulocyte donation could be associated with PSC formation. Transfusion medicine professionals should advise granulocyte apheresis donors to maintain an appropriate frequency of eye examinations.