Abstract
Purpose: :
To investigate the possible association of granulocyte apheresis donation with posterior subcapsular cataract (PSC) in a case-control study.
Methods: :
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.
Results: :
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).
Conclusions: :
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.
Keywords: cataract • clinical (human) or epidemiologic studies: risk factor assessment