Posterior subcapsular cataracts: histopathologic study of steroid-associated cataracts
J. V. Greiner and L. T. Chylack Jr
Long-term steroid therapy is associated with production of a posterior
subcapsular cataract (PSC). Five steroid-associated cataractous lenses were
studied, using light, scanning, and transmission electron microscopy.
Anterior, equatorial, and posterior regions were examined. Findings were
compared with five age-matched senile PSCs and five nuclear cataractous
lenses with no cortical opacities. The posterior polar region of
steroid-associated cataractous lenses consists of (1) a superficial zone of
liquefaction and (2) a deep zone of segmentally swollen lens fibers.
Nucleated lens fibers are present in posterior cortical regions. Cytoplasm
at knob and socket junctions had become lucent and plasma membranes were
disappearing, leaving empty spaces. Laminated membranous configurations
were seen. Although the same basic histopathologic abnormalities were found
in steroid-associated cataracts and in nonsteroid senile PSCs, it is their
organization and localization that may be the distinguishing
characteristics of the steroid-associated cataract.
