Background: Ionizing radiation (IR) can affect the brain and the visual organ even at low doses, while provoking cognitive, emotional, behavioral, and visual disorders. We proposed to consider the brain and the visual organ as potential targets for the influence of IR with the definition of cerebro-ophthalmic relationships as the «eye-brain axis».
Objective: The present work is a narrative review of current experimental, epidemiological and clinical data on radiation cerebro-ophthalmic effects in children, individuals exposed in utero, astronauts and interventional radiologists.
Materials and methods: The review was performed according to PRISMA guidelines by searching the abstract and scientometric databases PubMed/MEDLINE, Scopus, Web of Science, Embase, PsycINFO, Google Scholar, published from 1998 to 2021, as well as the results of manual search of peer-reviewed publications.
Results: Epidemiological data on the effects of low doses of IR on neurodevelopment are quite contradictory, while data on clinical, neuropsychological and neurophysiological on cognitive and cerebral disorders, especially in the left, dominant hemisphere of the brain, are nore consistent. Cataracts (congenital - after in utero irradiation) and retinal angiopathy are more common in prenatally-exposed people and children. Astronauts, who carry out longterm space missions outside the protection of the Earth's magnetosphere, will be exposed to galactic cosmic radiation (heavy ions, protons), which leads to cerebro-ophthalmic disorders, primarily cognitive and behavioral disorders and cataracts. Interventional radiologists are a special risk group for cerebro-ophthalmic pathology - cognitivedeficits, mainly due to dysfunction of the dominant and more radiosensitive left hemisphere of the brain, andcataracts, as well as early atherosclerosis and accelerated aging.
Conclusions: Results of current studies indicate the high radiosensitivity of the brain and eye in different contingents of irradiated persons. Further research is needed to clarify the nature of cerebro-ophthalmic disorders in different exposure scenarios, to determine the molecular biological mechanisms of these disorders, reliable dosimetric support and taking into account the influence of non-radiation risk factors.
Peredumova. Ionizuiuche vyprominiuvannia (IV) mozhe vplyvaty na golovnyĭ mozok ta organ zoru navit' za diï ma-lykh doz, vkliuchaiuchy kognityvni, emotsiĭno-povedinkovi ta zorovi rozlady. Namy zaproponovano rozgliadaty golov-nyĭ mozok ta organ zoru iak potentsiĭni misheni dlia vplyvu IV z vyznachenniam tserebrooftal'mologichnykhvzaiemozv’iazkiv iak «vis' ochi-mozok». Meta. Metoiu danoï roboty buv analitychnyĭ ogliad suchasnykh eksperymental'nykh, epidemiologichnykh i klinichnykh da-nykh stosovno radiatsiĭnykh tserebrooftal'mologichnykh efektiv u diteĭ, osib, eksponovanykh vnutrishn'outrobno, ast-ronavtiv ta interventsiĭnykh radiologiv.Materialy ta metody. Ogliad vykonano zgidno z nastanovamy PRISMA shliakhom poshuku u referatyvnykh ta nauko-metrychnykh bazakh PubMed/MEDLINE, Scopus, Web of Science, Embase, PsycINFO, Google Scholar, opryliudnenykh z1998 do 2021 roku, a takozh rezul'taty ruchnogo poshuku publikatsiĭ u vydanniakh, shcho retsenzuiut'sia. Rezul'taty. Epidemiologichni dani shchodo efektiv vplyvu malykh doz IV na neĭrorozvytok ie dovoli superechlyvymy,ale otrymano uzgodzhuvani klinichni, neĭropsykhologichni ta neĭrofiziologichni dani shchodo kognityvnykh i tserebral'-nykh porushen', osoblyvo u liviĭ, dominantniĭ gemisferi golovnogo mozku. U vnutrishn'outrobno oprominenykh osibi diteĭ bil'sh poshyreni katarakta (vrodzhena – pislia oprominennia in utero) ta angiopatiia sitkivky. Astronavty, iakizdiĭsniuvatymut' dovgotryvali kosmichni misiï za mezhamy zakhystu magnitosfery Zemli, zaznavatymut' vplyvu galak-tychnogo kosmichnogo vyprominiuvannia (vazhkymy ionamy, protonamy), shcho pryzvodyt' do tserebrooftal'mologichnykhporushen', peredusim kognityvnykh i povedinkovykh rozladiv ta katarakty. Interventsiĭni radiology skladaiut' osob-lyvu grupu ryzyku rozvytku tserebrooftal'mologichnoï patologiï – kognityvnogo defitsytu, perevazhno za rakhunokdysfunktsiï dominantnoï ta bil'sh radiochutlyvoï livoï pivkuli golovnogo mozku, i katarakty, a takozh rann'ogo ate-rosklerozu ta pryskorenogo starinnia. Vysnovky. Rezul'taty suchasnykh doslidzhen' svidchat' pro radiochutlyvist' golovnogo mozku ta oka u riznykh kontyn-gentiv oprominenykh osib. Potribni podal'shi doslidzhennia z utochnenniam kharakteru tserebrooftal'mologichnykh po-rushen' za riznymy stsenariiamy oprominennia, vyznachenniam molekuliarno-biologichnykh mekhanizmiv tsykh porushen',nadiĭnym dozymetrychnym suprovodom i vrakhuvanniam vplyvu neradiatsiĭnykh chynnykiv ryzyku.
Keywords: brain; cerebro-ophthalmic effects; eye; interventional radiology; ionizing radiation; prenatal irradiation; radiation emergencies; space flights.
K. M. Loganovsky, P. A. Fedirko, D. Marazziti, K. V. Kuts, K. Yu. Antypchuk, I. V. Perchuk, T. F. Babenko, T. K. Loganovska, O. O. Kolosynska, G. Yu. Kreinis, S. V. Masiuk, L. L. Zdorenko, N. A. Zdanevich, N. A. Garkava, R. Yu. Dorichevska, Z. L. Vasilenko, V. I. Kravchenko, N. V. Drosdova, Yu. V. Yefimova, A. V. Malinyak.