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S. Vitale, J. A. Clayton, J. Kim, C. Conry-Cantilena, P. Byrne, G. F. Reed, S. F. Leitman; Prevalence of Posterior Subcapsular Cataracts in Volunteer Cytapheresis Donors. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2510.
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To investigate the possible association of granulocyte apheresis donation with posterior subcapsular cataract (PSC) in a case-control study.
We recruited 100 granulocyte donors (≥ 4 granulocyte donations; any number of platelet donations) and 100 age-sex-matched platelet-only donors to examine the risk of posterior subcapsular cataract (PSC). Granulocyte donors received dexamethasone 8 mg orally prior to donation. PSC was assessed by a masked ophthalmologist and by masked reading center lens photograph gradings (using the AREDS lens grading system and based on % opacification within the central 5 mm), or by medical record documentation of PSC as the reason for cataract extraction.
Granulocyte and platelet donors did not differ significantly with respect to age, gender, race, history of smoking, alcohol consumption, non-donation-related steroid exposure history, or other known PSC risk factors. 14 eyes of 10 granulocyte donors and 5 eyes of 4 platelet donors had PSC. After adjusting for potential confounders (age, history of ocular surgery or trauma, gender), granulocyte donors were more likely to have PSC than were platelet-only donors, although the odds ratio (OR) did not reach statistical significance (OR = 3.08, p = 0.08). Compared with platelet donors (4/100 with PSC), risk of PSC increased with number of granulocyte donations: 4-9 donations, 8.6% (OR = 2.25; p = 0.30); 10-19 donations, 9.5% (OR = 2.53; p = 0.21); and ≥ 20 donations, 13.0% (OR = 3.60; p = 0.11) (p = 0.06 for trend). Excluding eyes with a history of cataract extraction for PSC, 2.0% of platelet donors had PSC and the risk of PSC increased with number of granulocyte donations: 4-9 donations, 5.9% (OR = 4.45, p = 0.15); 10-19 donations, 4.8% (OR = 2.44, p = 0.37); and ≥ 20 donations, 13.0% (OR = 11.77, p=0.009), respectively (p = 0.04 for trend).
We did not demonstrate a statistically significant increased risk of PSC associated with granulocyte donation in healthy apheresis donors. However, although this makes a large risk unlikely, we can not 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. A larger study is necessary to precisely define the extent of the increased risk. Frequent granulocyte donors should consider regular eye examinations.
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