Xu Guoxu,Lou Hui,Zeng Xinwei,et al.Changes of ocular lens and fundus in patient after exposure to 192Ir at “5.7” accident in Nanjing[J].Chinese Journal of Radiological Medicine and Protection,2016,36(5):364-367
Changes of ocular lens and fundus in patient after exposure to 192Ir at “5.7” accident in Nanjing
Received:February 05, 2016  
DOI:10.3760/cma.j.issn.0254-5098.2016.05.011
KeyWords:192Ir  Bone marrow from of acute radiation sickness  Ocular lens  Fundus  Medical follow-up
FundProject:江苏省临床医学科技专项(BL2014040);江苏省卫生计生委2014-2015年度预防医学科研项目(Y2015024)
Author NameAffiliationE-mail
Xu Guoxu Department of Ophthalmology, Second Affiliated Hospital of Soochow University, Suzhou 215004, China  
Lou Hui Department of Ophthalmology, Second Affiliated Hospital of Soochow University, Suzhou 215004, China  
Zeng Xinwei Department of Ophthalmology, Second Affiliated Hospital of Soochow University, Suzhou 215004, China  
Wang Youyou Department of Nuclear Emergency Center, Second Affiliated Hospital of Soochow University, Suzhou 215004, China  
Liu Yulong Department of Nuclear Emergency Center, Second Affiliated Hospital of Soochow University, Suzhou 215004, China yulongliu2002@126.com 
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Abstract::
      Objective To make a summary of radiation-induced changes in ocular lens and retinal lesions based on dynamic follow-up of a patient exposed to a radiation exposure from 192Ir source accident, in order to provide the information and experience for the clinical diagnosis and treatment of such injury in emergency of a nuclear or radiation accident.Methods The examination methods included eye lens and visual acuity, slit-lamp examination, fundus examination, automated perimetry, optical coherence tomography (OCT) examination, fundus photography, and fundus fluorescein angiography (FFA). The patient was followed-up for 20 months. Comparative analyses were made of the follow-up results. Results One month after 192Ir radiation exposure, the visual acuities in both eyes were 1.0. Mild age-related opacities were observed in peripheral cortex, but the fundus looked normal. Twenty months later, the patient was followed-up. The visual acuities reduced to about 0.6, evident powder- and punctuate-like opacities could be observed in the cortex of the right lens, and mild turbid foci in the posterior polar and capsule. Multiple scotomata appeared in the superior temporal and inferior nasal in the right eye. The macular fovea thickness was not changed significantly in the right eye. Examination with fundus photography demonstrated mild optical nerve atrophy, drusens, and pale optic discs, while FFA examination showed punctuate or flocculent leakages in both eyes. Conclusions The lens opacity could be induced or accelerated by radiation exposure. In addition to the posterior capsule and pole cataracts, punctuate opacity within cortical layer may also occur. It also suggests that cataract and fundus injuries may occur later during long-term follow-up, even though the eyes may look normal during early examination after the patient exposed to the radiation.
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