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Philip Kurochkin, Sana Qureshi, Roy S Chuck, Jimmy K Lee; Effects of ferritin on the prevalence of cataracts. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6222.
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© ARVO (1962-2015); The Authors (2016-present)
Markedly elevated ferritin levels found in hereditary hyperferritinemia-cataractsyndrome (HHCS) have been linked to the early development of cataracts in these patients. Studies have shown that HHCS patients have 15 times the normal L-ferritin levels in their lenses. However, HHCS accounts for a very small percentage of patients with elevated ferritin levels. We explored the effects of chronically elevated ferritin levels in any disease process to see how it affects the prevalence of cataract formation and age of onset.
We conducted a retrospective epidemiological study of Montefiore Medical Center’s1.5 million patient population from 6/1997 - 6/2015. We selected patients with 4 documented ferritin tests, each at least 1 year apart and assembled three cohorts: 1) males, ferritin levels >300 ng/mL (N=589, avg. age 58.6), 2) females, ferritin levels >200 ng/mL (N=1026, avg. age 64.6), 3) cataract surgery patients (N=9,356, avg. age M 68.9, avg. age F 71.0 total avg. 70.2). 38 males (avg. age 68.3) and 59 females (avg. age 70.7) with hyperferritinemia underwent cataract surgery.
The overall prevalence of cataract surgery in the Montefiore population was 0.53% inmales, 0.72% in females, and 0.64% collectively. The prevalence of cataract surgery in males and females with hyperferritinemia was 6.45% and 5.75% respectively, and 6.01% collectively. The prevalence of cataract surgery in the total population compared to the prevalence in the single sex and collective hyperferritinemia groups was found to be statistically significant with p-values < 0.0001. Age stratified analysis was significant for increased cataracts in hyperferritinemia groups at decades 40-49 to 90-99.
Chronically high levels of ferritin may increase a patient’s risk of cataract development relative to the general population. As the underlying pathophysiology remains unclear future studies that measure the levels of L-ferritin in the cataracts of patients with chronically elevated ferritin caused by other disease processes can help elucidate whether increased cataract susceptibility stems from accumulation in the lens secondary to increased serum ferritin levels or direct production by lens epithelium.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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