Problems of Radiation Medicine and Radiobiology

P. A. Fedirko¹, T. F. Babenko¹, O. O. Kolosynska¹, R. E. Dorichevska¹, N. A. Garkava²,
V. O. Sushko¹

¹State Institution «National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine», 53 Yuriia Illienka St., Kyiv, 04050, Ukraine
²State Institution «Dnipropetrovsk Medical Academy of the Ministry of health of Ukraine», 9 Vernadsky St., Dnipro, 49044, Ukraine

CLINICAL TYPES OF CATARACTS IN A LONG-TERM PERIOD AFTER ACUTE RADIATION SICKNESS

Objective. to describe the clinical types of cataracts in the remote period after acute radiation sickness (ARS).
Materials and methods. Twenty four – thirty three years after the emergency exposure, a complete ophthalmologic examination of 53 reconvalescents of ARS conducted. The average age of patients at the time of the examination was (64.6 ± 1.2) years, the average radiation dose of the examined patients was (2.39 ± 0.17) Gy. Ophthalmologic examination included visometry with and without correction, tonometry, autorefractokeratometry, biomicroscopy on a slit lamp, retroillumination photography (infrared and color) of a lens. To evaluate the results of surveys used statistical methods: calculation of average values of quantitative indicators, estimation of probability difference by Student’s method.
Results. In 10 patients (17 eyes) of the 53 reconvalescents of ARS in the remote period after irradiation artifakia after surgical treatment was recognized. In all other patients, changes in the transparency of the lens were detected, and most patients had combined changes. Radiation cataract with it’s characteristic clinical picture was detected in 32 people, and in one more case, it’s first signs were recorded. But 14 reconvalescents of ARS in the remote period after irradiation had not radiation cataract.
Conclusions. Radiation cataract has not been detected in 14 reconvalescents of ARS in the remote period after irradiation; the radiation doses of these patients significantly exceeds the threshold levels. Therefore, the absence of it’s signs in the remote period in individuals exposed to doses above 2 Gy may indicate that this well-known radiation-induced effect is stochastic. Further analysis of the clinical features of the len’s pathology in the reconvalescents of ARS is promising for the study of the mechanism of damage to the lens in this category of victims of the Chornobyl accident.
Key words: radiation cataract, involutional cataract, lens, acute radiation sickness, reconvalescents, ionizing radiation, dose.

Problems of Radiation Medicine and Radiobiology.
2019;24:493-502. doi: 10.33145/2304-8336-2019-24-493-502

full text

1. Belyi DA, Bazyka AD, Bazyka DA. Evolution of health status in persons who survived acute radiation sickness in the result of the accident 50 at Chornobyl NPP (based on 29years followup) In: Bazyka D, Sushko V, Chumak A, et al., editors. Health effects of the Chornobyl accident – thirty years aftermath. Kyiv: DIA; 2016. p. 50-61.

2. Gunko NV. Efficacy evaluation of managed population shift in Ukraine from zone of obligate (compulsory) resettlement as a measure of public radiation protection. Probl Radiac Med Radiobiol. 2015;20:174-84.

3. Reste J, Zvagule T, Kurjane N, et al. Investigations on health conditions of Chernobyl nuclear power plant accident recovery workers from Latvia in late period after disaster. Proceedings of the Latvian Academy of sciences. Section B. 2016;70(5):257-65.

4. Vasylenko VV, Nechaev SYu, Tsigankov MYa, Ratia GG, Berkovskyy VB, Pikta VO, et al. Main internal dose-forming factors for inhabitants of contaminated regions at current phase of the Chernobyl nuclear power plant accident (Kyiv region as an example). Probl Radiac Med Radiobiol. 2015;20:147-56.

5. Vasylenko VV, Tsigankov MYa, Nechaev SYu, Pikta VO, Zadorozhna GM, Bilonyk AB. Peculiarities of internal radiation doses due to 137Cs and 90Sr intake in population from Zhytomyr oblast in a late period after the Chornobyl NPP accident. Probl Radiac Med Radiobiol. 2013;18:59-69.

6. Fedirko PA, Babenko TF, Dorichevska RY, Garkava NA. Retinal vascular pathology risk development in the irradiated at different ages as a result of Chornobyl NPP accident. Probl Radiac Med Radiobiol. 2015;20:467-75.

7. Merriam GR, Focht EF. A clinical study of radiation cataract and the relationship to dose. Am J Roentgenol Radium Ther Nucl Med. 1957;77(5):759-85.

8. International Comission on Radiological Protection. Dose dependence of non-stochastic effects. Publications 41. Ann ICRP. 1984;14(3). 33 p.

9. Buzunov V, Fedirko P. Ophthalmopathology in victims of the Chernobyl catastrophy - results of clinical epidemiological study. In: Junk AK, Kundiev Y, Vitte P, Worgul BV, editors. Ocular radiation risk assessment in populations exposed to environmental radiation contamination. Dordrecht, Boston, London: Kluwer Ac. Publish; 1999. p. 57-67.

10. Fedirko P. Eye: clinic, diagnostics, regularities and risks for development of eye pathology in Chornobyl catastrophe sufferers In: Serdiuk A, Bebeshko V, Bazyka D, et al., editors. Health effects of the Chornobyl accident – thirty years aftermath. Kyiv: DIA; 2011. p. 492-510.

11. IAEA: Nuclear safety review 2013 : GC(57)/INF/3. Vienna: IAEA/NSR; 2013.

12. Medvedovsky C. Criteria for the subjective assessment of cataracts. NATO advanced research workshop “Ocular Radiation Risk Assessment in Populations Exposed to Environmental Radiation Contamination”, Kyiv, J. 28, 1997 – Aug. 1, 1997. Program & Abstracts. Kyiv; 1997. p. 23.

13. Ministry of Health of Ukraine Order of 2001 Aug 6, No 322 [On introduction to the criteria for determination of cataracts in preliminary and periodic ophthalmological surveys of workers of nuclear power plants]. Ukrainian.

14. Gerasimov VI, Ermolova-Makovskaya AP, Ramzayev PV. [Dependence of dose-effect on the estimation of the frequency of radiation cataract occurrence]. Medical Radiology. 1986;(4):52-5. Russian.

15. Milovidova IA. [Determination of the latent period of radiation cataract]. Medical Radiology. 1981;(9):52-56. Russian.

16. Fedirko PA. [Radiation cataract as a remote consequence of the Chornobyl catastrophy]. Bulletin of Scientific Research. 2000;(2):46-8. Ukrainian.

17. Cogan DG, Dreisler KK. Minimal amount of x-ray exposure causing lens opacities in the human eye. AMA Arch Ophthalmol. 1953;50(1):30-4.

18. Hall P, Granath F, Lundell M, Olsson K, Holm L-E. Lenticular opacities in individuals exposed to ionizing radiation in infancy. Radiat Res. 1999;152(1):190-5. DOI: https://doi.org/10.2307/3580093.

19. Chylack LT, Wolfe JK, Singer DM, et al. The lens opacities classification system III. The Longitudinal Study of Cataract Study Group. Arch Ophthalmol. 1993;111(6):831-6. DOI: 10.1001/archopht.1993.01090060119035.

20. Fedirko PA. [Method of determining the degree of turbidity of the human lens]. Patent 59860 Ukraine, IPC A61B 3/10. No. u201000235; Declared 13th January 2010; published 10th of June 2011, Bull. No. 11; 2011. Ukrainian.