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Catheter Cardiovasc Interv. 2018 Mar 1;91(4):647-654. doi: 10.1002/ccd.27173. Epub 2017 Jul 14.

Radiation-associated lens changes in the cardiac catheterization laboratory: Results from the IC-CATARACT (CATaracts Attributed to RAdiation in the CaTh lab) study.

Author information

1
Department of Cardiology, VA North Texas Healthcare System and University of Texas Southwestern Medical Center, Dallas, Texas.
2
Cosmos Eye Center, Athens, Greece.
3
Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts.
4
Division of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York.
5
Division of Cardiovascular Medicine, University of California San Diego, La Jolla, California.
6
Heart and Vascular Institute, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania.
7
Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, Minnesota.

Abstract

OBJECTIVE:

To examine the relationship between occupational exposure to ionizing radiation and the prevalence of lens changes in interventional cardiologists (ICs) and catheterization laboratory ("cath-lab") staff.

BACKGROUND:

Exposure to ionizing radiation is associated with the development of lens opacities. ICs and cath-lab staff can receive high doses of ionizing radiation without protection, and may thus be at risk for lens opacity formation.

METHODS:

We conducted a cross-sectional study at an interventional cardiology conference. Study participants completed a questionnaire pertaining to occupational exposure to radiation and potential confounders for the development of cataracts, followed by slit-lamp examination and grading of lens findings.

RESULTS:

A total of 117 attendees participated in the study, including 99 (85%; 49 ± 11 years-old; 82% male) with occupational exposure to ionizing radiation and 18 (15%; 39 ± 12 years-old; 61% male) unexposed controls. The prevalence of overall cortical and posterior subcapsular lens changes (including subclinical findings) was higher in exposed participants compared with controls (47 vs. 17%, P = 0.015). Occupational exposure and age over 60 were independent predictors of lens changes (odds ratio [95% CI]: 6.07 [1.38-43.45] and 7.72 [1.60-43.34], respectively). The prevalence of frank opacities was low and similar between the two groups (14 vs. 6%, P = 0.461). Most lens findings consisted of subclinical changes in the periphery of the lens without impact on visual acuity.

CONCLUSIONS:

Compared with unexposed controls, ICs and cath-lab staff had a higher prevalence of lens changes that may be attributable to ionizing radiation exposure. While most of these changes were subclinical, they are important due to the potential to progress to clinical symptoms, highlighting the importance of minimizing staff radiation exposure.

KEYWORDS:

cataract; catheterization; lens; occupational hazard; radiation

PMID:
28707381
DOI:
10.1002/ccd.27173

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