Acute retinal pigment epitheliitis and dosimetric follow-up: a case report
DOI:
https://doi.org/10.31288/oftalmolzh202425256Keywords:
acute retinal pigment epitheliitis, ionizing radiation, macula, retina, optical coherence tomography, morphological changes, incorporation of radioactive isotopesAbstract
Acute retinal pigment epitheliitis (ARPE; also known as Krill disease), a disease first described in the nineteen seventies, is characterized by fine pigment stippling in the macular area, surrounded by hypopigmented halo.
The etiology of the disease is not yet known. The patient reported that he used to eat berries picked from the forest in the radioactive contaminated area in late June to early July, 2023. He complained of transient metamorphopsia and reduced vision in the left eye, and received eye examination including optical coherence tomography, general check-up, blood cell counts and whole body radionuclide content study. He was diagnosed with bilateral APRE. On the basis of measurements with the expert whole-body counter, the wholebody burden of Сs-137 for the patient was 505 Bq, and the estimated annual effective dose from internal radiation was 0.011 mSv/y. The estimated dose value was substantially lower than the basic dose limit for the population of 1 mSv/y as per requirement of the Law of Ukraine. Because APRE is a rare disease with an unknown etiology, careful attention deserves to be given to the finding of the disease in a patient who has sustained short-term exposure to ionizing radiation due to the incorporation of Сs-137 into his body tissues.
For the first time it has become possible to assess adequately doses from internal radiation in a patient with APRE, which will allow to optimize efforts for further research on the etiology of this rare disorder.
References
Krill AE, Deutman AF. Acute retinal pigment epitheliitus. Am J Ophthalmol. 1972; 74:193-205. https://doi.org/10.1016/0002-9394(72)90535-1
Han SY, Cho SW, Lee DW, Lee TG, Kim CG, Kim JW. Acute retinal pigment epitheliitis: spectral-domain optical coherence tomography findings in 18 cases. Invest Ophthalmol Vis Sci. 2014; 55(5):3314-3319. https://doi.org/10.1167/iovs.14-14324
Kılıç R. Acute retinal pigment epitheliitis: a case presentation and literature review. Arq Bras Oftalmol. 2021; 84(2):186-190. https://doi.org/10.5935/0004-2749.20210028
Al-Nofal M, Charbel Issa P. Acute retinal pigment epitheliitis, a diagnostic myth? Eye. 2024; 38:238-239. https://doi.org/10.1038/s41433-023-02683-w
Iu LPL, Lee R, Fan MCY, Lam WC, Chang RT, Wong IYH. Serial spectral-domain optical coherence tomography findings in acute retinal pigment epitheliitis and the correlation to visual acuity. Ophthalmology. 2017; 124 (6): 903-909. https://doi.org/10.1016/j.ophtha.2017.01.043
Babenko TF, Fedirko PA, Dorichevska RY, Denysenko NV, Samoteikina LA, Tyshchenko OP. The risk of macular degeneration development in persons antenatally irradiated as a result of Chornobyl NPP accident. Probl Radiac Med Radiobiol. 2016 Dec:21:172-177. https://doi.org/10.33145/2304-8336-2016-21-172-177
Mao XW, Boerma M, Rodriguez D, Campbell-Beachler M, Jones T, Stanbouly S, et al. Acute effect of low-dose space radiation on mouse retina and retinal endothelial cells. Rad Res. 2018; 190 (1): 45-52. https://doi.org/10.1667/RR14977.1
Fedirko PA, Babenko TF, Kolosynska OO, et al. Morphometric parameters of retinal macular zone in reconvalescents of acute radiation sickness (in remote period). Probl Radiac Med Radiobiol. 2018;23:481-489. https://doi.org/10.33145/2304-8336-2018-23-481-489
Rios CI, Cassatt DR, Hollingsworth BA, Satyamitra MM, Tadesse YS, Taliaferro LP, et al. Commonalities Between COVID-19 and Radiation Injury. Rad Res. 2020; 195 (1): 1-24 https://doi.org/10.1667/RADE-20-00188.1
Babenko TF, Loganovsky KM, Loganovska TK, Medvedovska NV, Kolosynska OO, Garkava NA, et al. Brain and eye as potential targets for ionizing radiation impact. Part III/ Features morphometric retinal parameters, amplitude and latency components of visual evoked potential in radiation exposed in utero. Probl Radiac Med Radiobiol. 2021; 26:284-296. https://doi.org/10.33145/2304-8336-2021-26-284-296
Molchaniuk NI, Dumbrova NE. [Ultrastructural changes of nerve elements and retinal microvessels in rats exposed to radiation factors of the Chornobyl accident]. Oftalmol Zh. 2002;(6):44-49. Russian.
Vasylenko VV, Zadorozhna GM, Kuriata MS, Lytvynets LO, Novak DV, Mishchenko LP. Evaluation of main foodstuffs consumption by residents of particular settlements on radiologically contaminated territories of Ukraine. Probl Radiac Med Radiobiol. 2019 Dec;24:93-108. https://doi.org/10.33145/2304-8336-2019-24-93-108
Bazyka DA, Fedirko PA, Vasylenko VV, Kolosynska OO, Yaroshenko ZS, Kuriata MS, et al. Results of WBC-monitoring of firefighters participating in response to Chornobyl forest fires in April-May 2020. Probl Radiac Med Radiobiol. 2020 Dec; 25:177-87. https://doi.org/10.33145/2304-8336-2020-25-177-187
Fedirko PA, Babenko TF, Dorichevska RY, Garkava NA. Probl Radiac Med Radiobiol. Retinal vascular pathology risk development in the irradiated at different ages as a result of Chernobyl NPP accident. Probl Radiac Med Radiobiol. 2015 Dec; 20:467-573. https://doi.org/10.33145/2304-8336-2015-20-467-473
Fedirko PA, Garkava NA. Patterns of development of retinal vascular pathology at remote time period after radiation exposure. J Ophthalmol (Ukraine). 2016;6:24-28. https://doi.org/10.31288/oftalmolzh201662428
Nechayev SY, Vasylenko VV, Pikta VO, et al. [Monitoring of internal exposure doses of the population in the later stage of the Chernobyl NPP accident using whole body counters]. Kyiv: Research Center for Radiation Medicine of the Academy of Medical Sciences of Ukraine; 2010. Ukrainian.
Paquet F, Bailey MR, Leggett RW, Lipsztein J, Marsh J, Fell TP, et al. Occupational Intakes of Radionuclides: Part 3. Ann ICRP. 2017 Dec;46(3-4):1-486. https://doi.org/10.1177/0146645317734963
Law of Ukraine. On protection of the person against influence of ionizing radiation. Information of the Verkhovna Rada of Ukraine (VVR). 1998. № 22 URL: https://zakon.rada.gov.ua/laws/show/15/98
Zarins J, Pilmane M, Sidhoma E, Salma I, Locs J. The Role of Strontium Enriched Hydroxyapatite and Tricalcium Phosphate Biomaterials in Osteoporotic Bone Regeneration. Symmetry. 2019; 11 (2): 229. https://doi.org/10.3390/sym11020229
Zarins J, Pilmane M, Sidhoma E, et al. Immunohistochemical evaluation after Sr-enriched biphasic ceramic implantation in rabbits femoral neck: comparison of seven different bone conditions. J Mater Sci: Mater Med. 2018; 29 (8): 119. https://doi.org/10.1007/s10856-018-6124-7
Soysal GG, Berhuni M, Özcan ZO, Tıskaoğlu NS, Kaçmaz Z. Decreased choroidal vascularity index and subfoveal choroidal thickness in vitamin D insufficiency. Photodiagnosis Photodyn Ther. 2023; 44: 103767. https://doi.org/10.1016/j.pdpdt.2023.103767
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Тетяна Бабенко, Павло Федірко, Станіслав Саксонов, Ірина Шевченко, Мара Пильмане, Валентина Василенко, Олександра Коробова, Наталя Гарькава, Микола Курята
This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under a Creative Commons Attribution 4.0 International (CC BY 4.0) that allows users to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author as long as they cite the source.
COPYRIGHT NOTICE
Authors who publish in this journal agree to the following terms:
- Authors hold copyright immediately after publication of their works and retain publishing rights without any restrictions.
- The copyright commencement date complies the publication date of the issue, where the article is included in.
DEPOSIT POLICY
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) during the editorial process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work with an acknowledgement of its initial publication in this journal.
- Post-print (post-refereeing manuscript version) and publisher's PDF-version self-archiving is allowed.
- Archiving the pre-print (pre-refereeing manuscript version) not allowed.