Glaucoma in Atomic Bomb Survivors

Kiuchi, Yoshiaki; Yokoyama, Tomoko; Takamatsu, Michiya; Tsuiki, Eiko; Uematsu, Masafumi; Kinoshita, Hiroki; Kumagami, Takeshi; Kitaoka, Takashi; Minamoto, Atsushi; Neriishi, Kazuo; Nakashima, Eiji; Khattree, Ravindra; Hida, Ayumi; Fujiwara, Saeko; Akahoshi, Masazumi

doi:10.1667/rr3273.2

Cited by 29 publications

(36 citation statements)

References 25 publications

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“…Glaucoma is not life threatening but causes irreversible visual field loss, which, unlike cataract, is incurable. Normal-tension glaucoma (but not other types of glaucoma) was associated with radiation exposure with an odds ratio of 1.31 at 1 Gy (95% CI: 1.11, 1.53) [48]. Taken together, associations between radiation exposure and life-threatening respiratory disease were found for pneumonia/influenza, but these appeared partially attributable to incident cancer and/or CVD [49].…”

Section: Future Prospectsmentioning

confidence: 99%

Classification of radiation effects for dose limitation purposes: history, current situation and future prospects

Hamada

Fujimichi

2014

Journal of Radiation Research

167

105

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Radiation exposure causes cancer and non-cancer health effects, each of which differs greatly in the shape of the dose–response curve, latency, persistency, recurrence, curability, fatality and impact on quality of life. In recent decades, for dose limitation purposes, the International Commission on Radiological Protection has divided such diverse effects into tissue reactions (formerly termed non-stochastic and deterministic effects) and stochastic effects. On the one hand, effective dose limits aim to reduce the risks of stochastic effects (cancer/heritable effects) and are based on the detriment-adjusted nominal risk coefficients, assuming a linear-non-threshold dose response and a dose and dose rate effectiveness factor of 2. On the other hand, equivalent dose limits aim to avoid tissue reactions (vision-impairing cataracts and cosmetically unacceptable non-cancer skin changes) and are based on a threshold dose. However, the boundary between these two categories is becoming vague. Thus, we review the changes in radiation effect classification, dose limitation concepts, and the definition of detriment and threshold. Then, the current situation is overviewed focusing on (i) stochastic effects with a threshold, (ii) tissue reactions without a threshold, (iii) target organs/tissues for circulatory disease, (iv) dose levels for limitation of cancer risks vs prevention of non-life-threatening tissue reactions vs prevention of life-threatening tissue reactions, (v) mortality or incidence of thyroid cancer, and (vi) the detriment for tissue reactions. For future discussion, one approach is suggested that classifies radiation effects according to whether effects are life threatening, and radiobiological research needs are also briefly discussed.

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Section: Future Prospectsmentioning

confidence: 99%

Classification of radiation effects for dose limitation purposes: history, current situation and future prospects

Hamada

Fujimichi

2014

Journal of Radiation Research

167

105

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“…Low-dose radiation induces molecular networks and pathways associated with compromised cognitive function in advanced aging and Alzheimer’s disease or dementia within just a few hours of low dose exposure 14 . Moreover, a dose-dependent increase in normal tension glaucoma (NTG) with an odds ratio of 1.31 following irradiations of 1 Gy was reported in atomic bomb survivors 15 . While the mechanism of the increase in NTG by irradiation is unclear, the possible presence of neural progenitor cells in human retina has also been reported 16 .…”

mentioning

confidence: 99%

Effects of Chronic Low-Dose Radiation on Human Neural Progenitor Cells

Katsura

Cyou-Nakamine

Zen

et al. 2016

Sci Rep

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The effects of chronic low-dose radiation on human health have not been well established. Recent studies have revealed that neural progenitor cells are present not only in the fetal brain but also in the adult brain. Since immature cells are generally more radiosensitive, here we investigated the effects of chronic low-dose radiation on cultured human neural progenitor cells (hNPCs) derived from embryonic stem cells. Radiation at low doses of 31, 124 and 496 mGy per 72 h was administered to hNPCs. The effects were estimated by gene expression profiling with microarray analysis as well as morphological analysis. Gene expression was dose-dependently changed by radiation. By thirty-one mGy of radiation, inflammatory pathways involving interferon signaling and cell junctions were altered. DNA repair and cell adhesion molecules were affected by 124 mGy of radiation while DNA synthesis, apoptosis, metabolism, and neural differentiation were all affected by 496 mGy of radiation. These in vitro results suggest that 496 mGy radiation affects the development of neuronal progenitor cells while altered gene expression was observed at a radiation dose lower than 100 mGy. This study would contribute to the elucidation of the clinical and subclinical phenotypes of impaired neuronal development induced by chronic low-dose radiation.

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“…After high doses, neovascular glaucoma typically develops relatively quickly, within 3 years after radiotherapy 28 , 29 ; it is possible that both it and other types of glaucoma develop more slowly after lower doses, like other tissue reaction effects 32 , although there is no evidence of that here. In contrast to the situation at radiotherapeutic levels of dose, at the much lower doses received by the atomic bomb survivors normal-tension glaucoma, a subtype of primary open-angle glaucoma, was the only glaucoma subtype associated with radiation exposure 19 . The risks factors apart from radiation were quite distinct for normal-tension glaucoma in the LSS, limited to hypertension and obesity (with increased risk for those underweight) 19 .…”

Section: Discussionmentioning

confidence: 79%

“…There are well-documented associations of (often neovascular) glaucoma with high dose radiotherapeutic procedures 17 , 18 . Only normal-tension glaucoma has been observed in excess in the Japanese atomic-bomb survivors 19 . There is evidence of association of retinal degeneration with radiation dose in the Japanese atomic-bomb survivors 20 , but no association with macular degeneration as such 21 .…”

Section: Introductionmentioning

confidence: 99%

Occupational radiation exposure and glaucoma and macular degeneration in the US radiologic technologists

Little

Kitahara

Cahoon

et al. 2018

Sci Rep

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There are well-documented associations of glaucoma with high-dose radiation exposure, but only a single study suggesting risk of glaucoma, and less conclusively macular degeneration, associated with moderate-dose exposure. We assessed risk of glaucoma and macular degeneration associated with occupational eye-lens radiation dose, using participants from the US Radiologic Technologists Study, followed from the date of surveys in 1994–1998, 2003–2005 to the earliest of diagnosis of glaucoma or macular degeneration, cancer other than non-melanoma skin cancer, or date of last survey (2012–2014). We excluded those with baseline disease or previous radiotherapy history. Cox proportional hazards models with age as timescale were used. There were 1631 cases of newly self-reported doctor-diagnosed cases of glaucoma and 1331 of macular degeneration among 69,568 and 69,969 eligible subjects, respectively. Estimated mean cumulative eye-lens absorbed dose from occupational radiation exposures was 0.058 Gy. The excess relative risk/Gy for glaucoma was −0.57 (95% CI −1.46, 0.60, p = 0.304) and for macular degeneration was 0.32 (95% CI −0.32, 1.27, p = 0.381), suggesting that there is no appreciable risk for either endpoint associated with low-dose and low dose-rate radiation exposure. Since this is the first examination of glaucoma and macular degeneration associated with low-dose radiation exposure, this result needs to be replicated in other low-dose studies.

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Glaucoma in Atomic Bomb Survivors

Cited by 29 publications

References 25 publications

Classification of radiation effects for dose limitation purposes: history, current situation and future prospects

Classification of radiation effects for dose limitation purposes: history, current situation and future prospects

Effects of Chronic Low-Dose Radiation on Human Neural Progenitor Cells

Occupational radiation exposure and glaucoma and macular degeneration in the US radiologic technologists

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