Quantitative evaluation of light scattering intensities of the crystalline lens for radiation related minimal change in interventional radiologists: a cross-sectional pilot study

Abstract

To evaluate low-dose X-ray radiation effects on the eye by measuring the amount of light scattering in specific regions of the lens, we compared exposed subjects (interventional radiologists) with unexposed subjects (employees of medical service companies), as a pilot study. According to numerous exclusionary rules, subjects with confounding variables contributing to cataract formation were excluded. Left eye examinations were performed on 68 exposed subjects and 171 unexposed subjects. The eye examinations consisted of an initial screening examination, followed by Scheimpflug imaging of the lens using an anterior eye segment analysis system. The subjects were assessed for the quantity of light scattering intensities found in each of the six layers of the lens. Multiple stepwise regression analyses were performed with the stepwise regression for six variables: age, radiation exposure, smoking, drinking, wearing glasses and workplace. In addition, an age-matched comparison between exposed and unexposed subjects was performed. Minimal increased light scattering intensity in the posterior subcapsular region showed statistical significance. Our results indicate that occupational radiation exposure in interventional radiologists may affect the posterior subcapsular region of the lens. Since by its very nature this retrospective study had many limitations, further well-designed studies concerning minimal radiation-related lens changes should be carried out in a low-dose exposure group.

Lifetime study in mice after acute low-dose ionizing radiation: a multifactorial study with special focus on cataract risk

“…Compared to slit lamp retroillumination, the Scheimpflug system allows objective quantification of posterior capsule opacification much easier because the images are free of flash reflections (Jain and Grewal 2009 ). Using the Scheimpflug technique, Jeon and Kim ( 2011 ) observed 26% posterior-subcapsular cataracts among highly myopic patients who underwent cataract surgery, and Abe et al ( 2013 ) reported also posterior-subcapsular opacities after radiation exposure.…”

Hand Surgery and Fluoroscopic Eye Radiation Dosage

“…2,7,12,14 The intensive use of fluoroscopy among unprotected interventional cardiologists and nurses, compared with a matched control group, has been associated with statistically significant dose-dependent increased risk of posterior lens opacities. 2,7,9,14 Moreover, a 20-year prospective cohort study, among over 35 000 radiological technologists, has reported that exposure to fluoroscopic radiation doses, lower than recommended by the International Commission on Radiological Protection (ICRP), may increase the long-term risk of cataract formation. 6 Similar studies have proposed a correlation linking excessive radiation to the eye lens with the increased prevalence of early onset cataracts.…”

“…The World Health Organization has recognized cataract as the most prevalent eye disease in the world, and the association of excessive eye radiation exposure and the premature development of cataracts has been previously reported. 2,7,12,14,21 The current concept on the pathogenesis of radiation-induced cataract formation suggests that oxidative stress generated by elevated radiation levels results in the generation of reactive oxygen species and increased DNA damage at the lens epithelium. Such cumulative eye damage may result in cataracts and diminished visual acuity.…”

“…6 Similar studies have proposed a correlation linking excessive radiation to the eye lens with the increased prevalence of early onset cataracts. 2,7,9,15,21 While future long-term radiation safety studies are indicated, these authors suggested that, as a precaution, ocular radioprotection should be mandatory in the interventional radiology suite. 7 Similarly, Jacob et al 9 found that protective lead glasses lowered the risk of developing posterior subcapsular cataracts in interventional cardiologists.…”

Radiation dose reduction during neurointerventional procedures by modification of default settings on biplane angiography equipment

“…For instance, skin erythema is associated with an exposure threshold of approximately 2 Gy and permanent skin injury with an exposure threshold of about 5 Gy 4 5. For operators, the eye lens is susceptible and cataract risk increases with acute exposure as low as 0.1 Gy and chronic exposure of 5 Gy 6. The potential long-term effects to patients from repetitive exposure to ionizing radiation during medical procedures, however, are less well understood,7 and the cumulative stochastic effects on operators and support personnel from chronic low-level radiation exposure remain unclear 8 9.…”