ABSTRACT
In recent decades, several large-scale epidemiological surveys of the eyes have been conducted to determine the global prevalence of retinal degenerative diseases (for example, the Blue Mountains Eye Study). The results of such studies were evaluated several decades, and the studies themselves required significant material resources. Such large-scale projects have not been carried out in Ukraine.Objective of the work is to study the prevalence of age-related macular degeneration in a pilot group of non-irradiated persons of working age to determine the suitability of using the results for further epidemiological studies in Ukraine. MATERIALS AND METHODS: A retrospective-prospective analysis of the prevalence of degenerative diseases of the retina in a pilot group of persons who underwent an in-depth examination, as they claimed to participate in works in harmful conditions (with ionizing radiation) was carried out. The results of primary ophthalmological examinations of 1,064 people, conducted between January 18, 2007 and October 29, 2009, were randomly selected. The age of the examinees at the time of examination ranged from 18.94 to 67.49 years, the number of persons aged 18 to 30, 30 to 40, and 40 to 50 years was approximately the same. The results of a standardized ophthalmological examination were used. RESULTS: In the pilot group of people in working age, the prevalence of age-related macular degeneration was 196.4 per 1,000 people. Hazard analysis showed that the relative risk of age-related macular degeneration increased with age and was 1.14 (95% CI 1.07-1.21) for individuals aged 30-39 years; in comparison with persons under the age of 30; 1.3 (95% CI 1.21-1.41) - for persons aged 40-49; 1.3 (95% CI 1.18-1.52) - for persons aged 50-59; 1.86 (95% CI 1.0-3.47) - for persons over 60 years of age. The odds ratio (OR) of having age-related macular degeneration for those aged 30-39 years compared with those younger than 30 years was 3.04 (95% CI 1.79-5.15); for persons aged 40-49 years - 5.49 (95% CI 3.31-9.09); for persons aged 50-59 years - 6.04 (95% CI 3.36-10.88); for persons aged 50-59 years - 6.04 (95% CI 3.36-10.88) and for persons older than 60 years - 13.71 (95% CI 3.68-51.15), p in all cases < 0.0001. CONCLUSIONS: It was established that the prevalence of age-related macular degeneration in non-irradiated individuals determined in the pilot group was high and statistically significantly increased with age. It is shown that the results of primary ophthalmological examinations of a pilot group of persons who applied for participation in works in harmful conditions (with ionizing radiation) are suitable for epidemiological studies of the frequency and course of degenerative retinal diseases in persons of working age in Ukraine. The obtained results are important for practical medicine, as they will allow us to assess the prospects needs for medical care in the secondary and tertiary care.
Subject(s)
Macular Degeneration , Humans , Middle Aged , Aged , Retrospective Studies , Prevalence , Macular Degeneration/epidemiology , Macular Degeneration/etiology , Radiation, Ionizing , World Health OrganizationABSTRACT
BACKGROUND: Ionizing radiation (IR) can affect the brain and the visual organ even at low doses, while provoking cognitive, emotional, behavioral, and visual disorders. We proposed to consider the brain and the visual organ as potential targets for the influence of IR with the definition of cerebro-ophthalmic relationships as the «eye-brain axis¼. OBJECTIVE: The present work is a narrative review of current experimental, epidemiological and clinical data on radiation cerebro-ophthalmic effects in children, individuals exposed in utero, astronauts and interventional radiologists. MATERIALS AND METHODS: The review was performed according to PRISMA guidelines by searching the abstract and scientometric databases PubMed/MEDLINE, Scopus, Web of Science, Embase, PsycINFO, Google Scholar, published from 1998 to 2021, as well as the results of manual search of peer-reviewed publications. RESULTS: Epidemiological data on the effects of low doses of IR on neurodevelopment are quite contradictory, while data on clinical, neuropsychological and neurophysiological on cognitive and cerebral disorders, especially in the left, dominant hemisphere of the brain, are nore consistent. Cataracts (congenital - after in utero irradiation) and retinal angiopathy are more common in prenatally-exposed people and children. Astronauts, who carry out longterm space missions outside the protection of the Earth's magnetosphere, will be exposed to galactic cosmic radiation (heavy ions, protons), which leads to cerebro-ophthalmic disorders, primarily cognitive and behavioral disorders and cataracts. Interventional radiologists are a special risk group for cerebro-ophthalmic pathology - cognitivedeficits, mainly due to dysfunction of the dominant and more radiosensitive left hemisphere of the brain, andcataracts, as well as early atherosclerosis and accelerated aging. CONCLUSIONS: Results of current studies indicate the high radiosensitivity of the brain and eye in different contingents of irradiated persons. Further research is needed to clarify the nature of cerebro-ophthalmic disorders in different exposure scenarios, to determine the molecular biological mechanisms of these disorders, reliable dosimetric support and taking into account the influence of non-radiation risk factors.
Subject(s)
Brain/radiation effects , Cosmic Radiation/adverse effects , Eye/radiation effects , Prenatal Exposure Delayed Effects , Radiation Injuries/etiology , Radiation, Ionizing , Space Flight , Adolescent , Adult , Astronauts/statistics & numerical data , Child , Child, Preschool , Eye/physiopathology , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Pregnancy , Radiation Dosage , Radiation Injuries/physiopathology , Radiologists/statistics & numerical data , Young AdultABSTRACT
One of the current problems of modern radiobiology is determine the characteristics of the manifestation of radiation-induced effects not only at different dose loads, but also at different stages of development of the organism. In previous reports, we have summarized available evidence that at certain ages there is a comparative acceleration of radiation-induced pathological changes in the eye and brain, and the study and assessment of the risk of possible ophthalmic and neurological pathology in remote periods after contamination of radioactive areas. Data of irradiated in utero individuals are possible on the basis of observation of the state of the visual analyzer in persons who underwent intrauterine irradiation in 1986. Therefore, a parallel study of retinal morphometric parameters, amplitude and latency of components of evoked visual potentials in irradiated in utero individuals was performed. OBJECTIVE: to evaluate the retinal morphometric parameters, amplitude and latency components of the evoked visual potentials in intrauterine irradiated persons. MATERIALS AND METHODS: The results of surveys of 16 people irradiated in utero in the aftermath of the Chornobyl disaster were used; the comparison group were residents of Kyiv of the corresponding age (25 people). Optical coherence tomography was performed on a Cirrus HD-OCT, Macular Cube 512x128 study technique was used. At the same time, the study of visual evoked potentials on the inverted pattern was performed, and occipital leads wereanalyzed. Visual evoked potentials were recorded on a reversible chess pattern (VEP) - an electrophysiological test, which is a visual response to a sharp change in image contrast when presenting a reversible image of a chessboard. RESULTS: In those irradiated in utero at the age of 22-25 years, there was a probable increase in retinal thickness in the fovea, there was a tendency to increase the thickness of the retina in the areas around the fovea. When recording visual evoked potentials on a reversible chess pattern in this group, there was a tendency to decrease the amplitudes of components (N75, P100, N145, P200) in the right and left parieto-occipital areas and asymmetric changes in latency of these components. CONCLUSIONS: Early changes of fovea recorded in OCT and decreasing amplitudes of components of visual evoked potentials on the reversible chess pattern at the age of 22 25 years may indicate a risk of development in patients irradiated in utero, early age-related macular degeneration, as well as increased risk and increased risk structures of the visual analyzer.
Subject(s)
Abnormalities, Radiation-Induced/physiopathology , Chernobyl Nuclear Accident , Evoked Potentials, Visual/radiation effects , Prenatal Exposure Delayed Effects/physiopathology , Radiation, Ionizing , Retina/anatomy & histology , Retina/radiation effects , Adult , Brain Diseases/physiopathology , Eye Diseases/physiopathology , Female , Humans , Male , Pregnancy , Ukraine , Young AdultABSTRACT
BACKGROUND: Exposure to ionizing radiation could affect the brain and eyes leading to cognitive and vision impairment, behavior disorders and performance decrement during professional irradiation at medical radiology, includinginterventional radiological procedures, long-term space flights, and radiation accidents. OBJECTIVE: The objective was to analyze the current experimental, epidemiological, and clinical data on the radiation cerebro-ophthalmic effects. MATERIALS AND METHODS: In our analytical review peer-reviewed publications via the bibliographic and scientometric bases PubMed / MEDLINE, Scopus, Web of Science, and selected papers from the library catalog of NRCRM - theleading institution in the field of studying the medical effects of ionizing radiation - were used. RESULTS: The probable radiation-induced cerebro-ophthalmic effects in human adults comprise radiation cataracts,radiation glaucoma, radiation-induced optic neuropathy, retinopathies, angiopathies as well as specific neurocognitive deficit in the various neuropsychiatric pathology including cerebrovascular pathology and neurodegenerativediseases. Specific attention is paid to the likely stochastic nature of many of those effects. Those prenatally and inchildhood exposed are a particular target group with a higher risk for possible radiation effects and neurodegenerative diseases. CONCLUSIONS: The experimental, clinical, epidemiological, anatomical and pathophysiological rationale for visualsystem and central nervous system (CNS) radiosensitivity is given. The necessity for further international studieswith adequate dosimetric support and the follow-up medical and biophysical monitoring of high radiation riskcohorts is justified. The first part of the study currently being published presents the results of the study of theeffects of irradiation in the participants of emergency works at the Chornobyl Nuclear Power Plant (ChNPP).