Space RAD Health Newsletter
Vol. 3 No. 2 - August 2003 | Executive Editor: Dr. Francis Cucinotta | Contributing Editor: Kay Nute

3rdInternational Workshop on Space Radiation Research Announced

A Map to the Future The 3rd International Workshop on Space Radiation Research will be held in conjunction with the 15th Annual Space Radiation Health Investigators' Workshop May 16-20, 2004 at Danfords on the Sound on the north shore of Long Island in Port Jefferson, New York.

This third International Workshop follows in the tradition of those held in Arona, Italy in 2000 and in Nara, Japan in 2002 and will provide an opportunity for investigators from around the world to share the results of their work and common goals of research to benefit the health and well-being of those who live and work in space.

A distinguished International Scientific Committee has been enlisted to steer the Workshop. Members are James Adams, Mauro Belli, Antone Brooks, John Dicello, Marco Durante, Dudley Goodhead, Jack Miller, Greg Nelson, Takeo Ohnishi, Vladislav Petrov, Guenther Reitz, Orlando Santos, Walter Schimmerling, Betsy Sutherland, Marcelo Vazquez, John Wilson, and Hiroshi Yasuda. The Organizing Committee, chaired by John Gatley, includes Francis Cucinotta, Marvin Frazier, Adrian LeBlanc, Derek Lowenstein, Greg Nelson, Walter Schimmerling, Frank Sulzman, Betsy Sutherland, and Marcelo Vazquez.

Preliminary program plans include plenary sessions, a poster session, and a special tour of the new NASA Space Radiation Laboratory at Brookhaven National Laboratory. Scientific sessions are anticipated on such topics as low dose radiation damage, dosimetry, DNA repair, cell signaling, shielding technologies, the bystander response, radiation-induced cataracts, and cosmic rays. Additional information about the Workshop may be found at the conference website.


Commissioning of the NSRL - NASA Space Research Laboratory

Three weeks of commissioning experiments for the new NASA Space Research Laboratory (NSRL) at Brookhaven National Laboratory (BNL) were successfully accomplished from July 7th through 23rd, following the completion of the facility's construction on June 30, 2003. The goals of the commissioning experiments were to test all major components of the new facility and to allow Brookhaven support staff to gain experience with new equipment and procedures prior to the first experimental campaign (called NSRL-1) scheduled for October 2003. Scientists participating in the commissioning experiments were asked to volunteer by submitting a scientific proposal with goals that supported commissioning. Participants included E. Behravesh (USRA, Houston), F. Cucinotta (NASA, JSC), E. Davis (MRC, UK), N. Desai (NASA, JSC), M. Durante (U. Naples, Italy), K. George (NASA, JSC), A. Gewirtz (U. Pennsylvania School of Medicine), L. Green (LLU), S. Guegersloh (LBNL), P. Guida (BNL), L. Heilbronn (LBNL), T. Jones (LLU), A. Kronenberg (LBNL), J. Miller (LBNL), G. Nelson (LLU), P. O'Neill (MRC, UK), M. Pecaut (LLU), A. Obenaus (LLU), C. Quesada (LLU), A. Rusek (BNL), A. Smith (LLU), B. Sutherland (BNL), J. Sutherland (BNL), H. Wu (NASA, JSC), M. Vazquez (BNL), and C. Zeitlin (LBNL). The participants were unanimous in their praise of the new facility for space radiation research. Lessons-learned from the commissioning experiments were collected from the participants and are under review by BNL and NASA-JSC personnel.

To assess beam characteristics, 150 beam hours were delivered for a variety of biological and physics experiments that studied three different charged particles in ten experimental groups. The three beam lines were iron (1 GeV/n, LET = 151 keV/µm), carbon (290 MeV/n, LET = 13 keV/µm), and titanium (1 GeV/n, 114 keV/µm). The first beam, Fe, was selected to allow direct comparisons to previous results at the BNL Alternating Gradient Synchrotron (AGS). The second beam, C, was selected to compare to data from the HIMAC facility in Japan, while the third beam, Ti, (1 GeV/n, 114 keV/µm) was selected as an unexplored ion representative of the many galactic cosmic ray (GCR) heavy ions with LETs near the predicted peak in biological effectiveness. For a few excerpts on these commissioning experiments from the news media, see the article - Radiation in Space: BNL Leads Research.

NSRL Experiments List
Figure-1: First test experiments at the NASA Space Research Laboratory (NSRL-0) during July 2003.

This unique radiation research facility will enhance NASA-sponsored radiobiology efforts to study the biological effects of accelerated charged particles simulating galactic cosmic rays and solar energetic particles and to develop mitigation approaches to these harmful rays. Control of experimental variables at NSRL, such as beam size, and dose-rates or particle intensity, including protons (with energies up to 3 GeV/n) and oxygen, silicon, titanium, iron (with energies exceeding 1 GeV/n), will enable new research possibilities. Based on the success of the NSRL commissioning experiments, it is anticipated that the NASA radiation biology research will be stepping ahead in the area of scientific achievement with goals that will enable the future human exploration of the space frontiers.

Dosimetry at NSRL
Figure-2: Photographs of the optical bench at the target area of the NSRL facility showing the dosimetry system and automated binary filter for studying variable amounts of polyethylene shielding. Also, shown is the observed Bragg peak for an iron beam with kinetic energy of 1GeV/n.
 

NASA Research Funding News

National Aeronautics and Space Administration (NASA) Research Announcement (NRA) NRA 02-OBPR-02 was released August 30, 2002 to solicit proposals for ground-based research in space radiation biology and space radiation shielding materials. This solicitation was planned to utilize the high-energy heavy nuclei produced at the new $34 million NASA Research Laboratory (NSRL) and the Alternating Gradient Synchrotron (AGS) at Brookhaven National Laboratory (BNL). These beams simulate the high-energy, high-charge (HZE) components of galactic cosmic rays that constitute the biologically most significant component of space radiation. The new NSRL irradiation facility at BNL, funded by NASA, is expected to start delivering beams for experiments in Fall/Winter of 2003.

After an extensive peer review process of the proposals received, the following researchers were selected to receive funding from this program:

  • John O. Archambeau
    Loma Linda University Medical College
    Loma Linda, California
    "Quantification of the Dose Response of the Microvessel Parameters in Retina, Cortex and White Matter Following Iron-56
    Irradiation and Proton"

  • Jeff W. Bacher
    Promega Corporation
    Madison, Wisconsin
    "A Novel Biodosimetry Method for Monitoring Radiation-Induced Genetic Damage"

  • Susan M Bailey
    Colorado State University
    Fort Collins, Colorado
    "HZE Radiation: Modulation of Genetic Effects by RNA Interference of NHEJ"

  • Eric Benton
    Eril Research Inc.
    Richmond, California
    "Radiation Shielding Properties of Multifunctional Spacecraft Materials"

  • Eleanor A. Blakely
    Lawrence Berkeley National Laboratory
    Berkeley, California
    "Early Markers of Space-Radiation-Induced Human Cataractogenesis"

  • Fredric J. Burns
    NYU School of Medicine
    Tuxedo, New York
    "A Study of Dietary Retinoid for Prevention of 56Fe-Induced Cancers in Rat Skin"

  • Polly Chang
    SRI International
    Menlo Park, California
    "Tissue-Specific Acute and Late Molecular Surveillance of Particle Radiation Effects"

  • S. John Gatley
    Brookhaven National Laboratory
    Upton, New York
    "MicroPET Studies of Brain Damage by Heavy Ion Particles"

  • Andrew Grosovsky
    University of California, Riverside
    Riverside, California
    "Mechanisms of Radiation-Induced Recombination and Mutagenesis"

  • Eric J. Hall
    Columbia University
    New York, New York
    "Individual Genetic Susceptibility"

  • Kathryn Held
    Massachusetts General Hospital
    Boston, Massachusetts
    "Induction of Bystander Effects by High LET Radiation in Cells and in Tissue Models"

  • David G. Hoel
    Medical University of South Carolina
    Charleston, South Carolina
    "The Analysis of the Potential Health Risks from High LET Radiation"

  • Raj Kaul
    NASA Marshall Space Flight Center
    Huntsville, Alabama
    "Experimental and Analytical Assessments of Polyethylene-Fiber Based Composites as Space-Radiation Shielding and Structural Materials"

  • Warren Kelliher
    NASA Langley Research Center
    Hampton, Virginia
    "Development of an Inflatable Multifunctional Damage Tolerant Wall Structure with High Radiation Attenuation Properties"

  • Ann R. Kennedy
    University of Pennsylvania School of Medicine
    Philadelphia, Pennsylvania
    "Mechanisms by Which Selenomethionine Protects Against Space Radiation Biological Effects"

  • Amy Kronenberg
    Lawrence Berkeley National Laboratory
    Berkeley, California
    "Comparative Analysis of Fe Ion-Induced Autosomal Mutations in Marine Tissue and Cell Lines"

  • Chuan-Yuan Li
    Duke University Medical Center
    Durham, North Carolina
    "Mechanisms of HZE Particle-Induced Genetic Instability/Oncogenic Transformation and Their Prevention"

  • Charles Limoli
    University of California, San Francisco
    San Francisco, California
    "High LET Radiation and Neurogenesis: Implications and Mechanisms Underlying Cognitive Impairement"

  • Joanne R. Lupton
    Texas A&M University
    College Station, Texas
    "Gene Expression Patterns Predictive of Radiation-Enhanced Colon Tumorigenesis: Diet as a Countermeasure"

  • Louis Mansur
    Oak Ridge National Laboratory
    Oak Ridge, Tennessee
    "Materials Science and Particle Transport Assessment of Novel and Multifunctional Shielding Materials"

  • Michael Moyers
    Loma Linda University Medical Center
    Loma Linda, California
    "HZE Upgrade and Verification of 3-D Transport Code"

  • Andre Obenaus
    Loma Linda University
    Loma Linda, California
    "Non-Invasive Assessment of Neuropathology Following CNS Radiation Exposure"

  • Bernard M. Rabin
    University of Maryland Baltimore Campus
    Baltimore, Maryland
    "Behavioral and Neurochemical Effects of Exposure to Heavy Particles"

  • Kanokporn Rithidech
    SUNY at Sony Brook
    Stony Brook, New York
    "In Vivo Induction of Chromosomal Damage: A Spectral Karyotyping Study"

  • Michael D. Story
    University of Texas M. D. Anderson Cancer Center
    Houston, Texas
    "Gene Expression Profile Analysis as a Prognostic Indicator of Normal Tissue Response to Simulated Space Radiations"

  • Betsy M. Sutherland
    Brookhaven National Laboratory
    Upton, New York
    "Complex Space Radiation-Induced DNA Damage Clusters in Human Cell Transformation: Mechanisms, Relationships and Mitigation"

  • Ya Wang
    Thomas Jefferson University
    Philadelphia, Pennsylvania
    "Checkpoint Reduced Cell Sensitivity to High Energy Particles-Induced Killing"

  • Yongliang Zhao
    Columbia University
    New York, New York
    "Functional Role of the Betaig-H3 Gene in High-Energy Heavy Ions-Induced Carcinogenesis"

 

The Department of Energy and NASA announced their interest in receiving grant applications for new research to develop a better scientific basis for understanding exposures and risks to humans from low dose and low fluence radiation. Projects of interest to the NASA/OBPR Space Radiation Health Program that will receive partial NASA support include the following:

    New 2003 projects

    • Eric Hall
      Columbia University
      "Individual Genetic Susceptibility"

    • Allan Balmain
      University of California San Francisco
      "Identification of Mouse Genetic Susceptibility to Radiation Carcinogenesis"

    • J. Leslie Redpath
      University of California Irvine
      "Low Dose Suppression of Neoplastic Transformation in vitro"

    Currently funded (since 2002) projects

    • Eric Ackerman
      Pacific Northwest National Laboratory
      "Effects of low doses of radiation DNA repair"

    • Michael Cornforth
      University of Texas Medical Branch
      "Cytogenetic response to low doses of Ionizing radiation"

    • John Ford
      Texas A & M University
      "Low dose response of respiratory cells in intact tissues and reconstituted tissue constructs"

    • Lora Green
      Loma Linda University
      "Low dose gamma irradiation potentiates secondary exposure to gamma rays or protons in thyroid tissue analogs"

    • Terumi Kohwi-Shigamatsu
      Lawrence Berkeley National Laboratory
      "SATB1 deficiency accounts for high susceptibility to low dose radiation" (funding augmented in 2003)

    • Betsy Sutherland
      Brookhaven National Laboratory
      "DNA damage clusters in low level radiation responses of human cells"

     

    A solicitation for proposals to fund a team of space radiation health investigators who have complementary skills and who work together to solve a closely focused set of research questions was closed June 2, 2003. This solicitation, NRA 03-OBPR-02, sought to fund NASA Specialized Centers of Research (NSCORs). In the past, NASA has funded NASA Specialized Centers of Research and Training (NSCORTs) in several areas, but the center(s) described in this solicitation were not planned to have an explicit training component and, hence, the abbreviated acronym. NSCOR team members may be located at home laboratories geographically contiguous or dispersed, as long as the team members have a mechanism for working together. The research will be conducted using ground-based irradiation facilities at the NASA Space Radiation Laboratory (NSRL) at Brookhaven National Laboratory (BNL) in Upton, New York.

    It is anticipated that there will be one award to each of three focused NSCOR research teams dealing with the biological consequences of space radiation on 1) increased risk of leukemia, 2) mechanisms of DNA damage and repair, and 3) the central nervous system. Each award will be funded as a research grant. Selected proposals will be funded in one-year increments for activities lasting up to five years. The funding duration will depend on proposal requirements, review panel recommendations, and continuing progress of the activity. All proposals will be evaluated for overall scientific and technical merit by independent peer review panels. It is estimated that initial selections will be announced by August 2003 and grants awarded shortly thereafter.


Space Radiation Health Investigators Convene in April

14th Annual NASA Space Radiation Health Investigators' Workshop

The 14th Space Radiation Health Investigators' Workshop was held April 27-30, 2003 at the South Shore Harbour Resort and Conference Center, League City, Texas. A total of 102 participants from the United States, Canada, Germany, Italy, Japan, and the United Kingdom were treated to Texas hospitality, enjoying a "pier review" of the Kemah waterfront and a gala banquet at Space Center Houston in addition to a jam-packed scientific program. Fifty-two oral talks and 16 posters were presented. The Proceedings includes a Final Program with links to abstracts, images of the Workshop activities, and a list of Workshop participants.

SRHP Featured Investigator: Leo T. Chylack, Jr., M.D.

Leo. T. Chylack, Jr., M.D. Leo T. Chylack, Jr., M.D.
Director, Center for Ophthalmic Research
Brigham and Women's Hospital
Boston, MA 02115

Internationally known for both his clinical and research expertise, Leo T. Chylack, Jr., M.D. is adding his research on the formation, epidemiology, and classification of cataracts to the body of space radiation health knowledge. As Principal Investigator for the grant "Precise Assessment of Prevalence and Progression Rates of Cataracts in Astronauts" Dr. Chylack will use his experience in classifying cataracts to assess the risk of accelerated lens opacification in astronauts. In a newly initiated NASA Supplementary Medical Objectives (SMO), "Precise Assessment of Prevalence and Progression Rates of Lens Opacities in Astronauts as a Function of Radiation Exposure in Space Flight and Development of Improved Routine Clinical Assessment of Ocular Lens Status," Dr. Chylack and his institution, the Brigham and Women's Hospital, will team with the NASA Johnson Space Center, the Baylor College of Medicine Department of Medicine, Clear Lake Eye Associates, and Wyle Laboratories for a five-year, multi-centered research study. The goal of the SMO is to determine the prevalence and progression rates of the three main types of age-related lens opacities in astronauts and to determine the risk of incident cataract and cataract progression associated with each component of radiation exposure during space flight.

After receiving his undergraduate degree in Biochemistry from Yale University in 1960, Dr. Chylack entered Harvard Medical School, graduating in 1964. He completed his internship in 1965, served as Chief Peace Corps Physician with the U.S. Public Health Service in Lima, Peru from 1965-67, and completed a fellowship in lens biochemistry in 1970 at the Howe Laboratory of Ophthalmology. He continued his affiliation with Harvard Medical School, completing a residency in Ophthalmology at the Massachusetts Eye & Ear Infirmary in 1971. From 1971-1997, he served as Chief, Division of Ophthalmology at Brigham & Women's Hospital. He was named Professor of Ophthalmology in 1989; since 1993 he has served as Director, Center for Ophthalmic Research, Brigham and Women's Hospital. He retains hospital appointments and consultancies with Beth Israel Hospital, Children's Hospital Medical Center, New England Deaconess Hospital, and the Massachusetts Eye and Ear Infirmary. Since 1993 he has also collaborated with the Human Nutrition Research Center on Aging at Tufts University to address the effects of antioxidative micronutrients on cataract.

In recognition for his research achievements, Dr. Chylack has been honored with awards from the Alcon Research Institute, American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology, National Foundation for Eye Research, New England Ophthalmological Society, Research to Prevent Blindness, Rhoto Pharmaceutical Company, Swedish Ophthalmological Society, and the Swedish Society of Medicine.

Dr. Chylack's interest in ophthalmology may have been genetically ordained; his father, Leo T. Chylack, M.D., was an opthalmologist in community practice in Pennsylvania, who greatly enjoyed his work and was, in turn, loved by his patients. Dr. Chylack, Jr.'s interest in the lens dates to his fellowship experiences with mentors Jin H. Kinoshita, Ph.D. and David G. Cogan, M.D., both pioneers in lens research at the Howe Laboratory and both of whom later continued their research at the National Eye Institute of the National Institutes of Health.

From the beginning of his career, Dr. Chylack has focused his research attentions on the lens of the eye - specifically on crystalline lens metabolism and cataract formation, charting precataractous changes and cataractous growth rates, classifying human age-related cataracts, clinical testing of potential anticataractous drugs, the epidemiology and etiology of age-related cataract, molecular mechanisms common to Alzheimer's disease and age-related cataract, the molecular biology of lens and cataract, growth and survival factors with focus on lens, digital methods to detect cataract progression, and specular microscopy of the crystalline lens. In addition to his extensive cataract studies, he has also examined the ocular manifestations of juvenile rheumatoid arthritis.

In the mid-1970s, Dr. Chylack and his colleagues developed a stereoscopic system of lens photography that enabled cataract changes to be classified; this methodology was accepted and adopted by the Cooperative Cataract Research Group. The ability to classify cataracts according to their location and to the extent of their severity has made a significant contribution to the standardization of cataract research. Over time, greater experience with numbers of cases, refinement in the diagnostic equipment used (slit-lamp images and retroillumination photography), and the reproducibility of the observation techniques applied have resulted in a much improved classification system: The Lens Opacities Classification System III. The revised and improved system has been widely used since 1993 as a method for measuring the severity of cataracts and detecting and grading longitudinal changes in cataract severity. More recently, Dr. Chylack and a group of international researchers developed a simplified cataract grading system for the World Health Organization. The WHO simplified cataract grading system should enable relatively inexperienced observers to use a slit lamp to grade the most common forms of cataract, increasing the reliability of epidemiological record keeping for tracking age-related cataract, which is the major cause of preventable blindness throughout the world.

Since the human exploration of space requires strict attention to the health and safety of the explorers, and since the space radiation environment is inherently hazardous and risk-filled, the goals of the Space Radiation Health Research Program are to accurately predict and to efficiently manage radiation risk. To that end, specific risks and questions focused on radiation health have been addressed in NASA's Bioastronautics Critical Path Roadmap (BCPR) document.

Based on new epidemiological information on degenerative risks from radiation, the risk of cataract has been proposed as an addition to a revised BCPR document. Root (or basic) questions that need to be addressed include:

  • What are the probabilities for cataractogenesis from protons and HZE ions as a function of NASA's operational parameters (age at exposure, age, gender, tissue, mission, radiation quality, dose-rate)?

  • What are the most effective operational, shielding, or biomedical countermeasures to cataract risks?

Specific critical questions, including those listed below, will be addressed in Dr. Chylack's five-year research plan.

  • What are the induction rates or RBE's for lens opacities (sub-clinical cataracts) and cataracts as a function of radiation type?

  • What are the progression rates for lens opacities and cataracts, and how do they change with age, gender, and radiation type?

  • How can the discovery of the precise mechanisms of cataract formation lead to improved risk assessment and countermeasures?

  • Can the study of radiation cataractogenesis be used as a model system for improving risk assessments or countermeasure development for other radiation risks?

The primary goal of the five-year study, "Astronauts, Exposure to Radiation in Space Flight, and Risk of Cataract" is to determine the prevalence and progression rates of the three main types of age-related lens opacities in the complete sample of astronauts and to determine the risk of incident cataract and cataract progression associated with each type of radiation exposure (protons, heavy ions, and galactic cosmic rays) during space flight. There will be two groups of control subjects: (1) military pilots and (2) ground-based JSC workers. These two control groups will enable the assessment of the cataractogenic risks of radiation encountered in high altitude flight (hence, the military pilots) versus that encountered by astronauts during space flight versus the control group of non-astronauts participating in the Longitudinal Study of Astronaut Health (LSAH). Another goal of the study is to improve the routine assessment of astronauts' lens status to enable the objective assessment of cataract and to track cataract type-specific progression rates. Results from the study should aid the planning of improved strategies to prevent or slow cataract progression.

  • Chylack LT Jr. Classification of human cataracts. Arch Ophthalmol 1978;96:888.
  • Chylack LT Jr, Lee MR, Tung WH, Cheng HM. Classification of human senile cataractous change by the American Cooperative Cataract Research Group (CCRG) method. I. Instrumentation and technique. Invest Ophthalmol Vis Sci 1983;24:424.
  • Chylack LT Jr, White O, Tung WH. Classification of human senile cataractous change by the American Cooperative Cataract Research Group (CCRG) method. II. Staged simplification of cataract classification. Invest Ophthalmol Vis Sci 1984;25:166.
  • Chylack LT Jr, Ransil BJ, White O. Classification of human senile cataractous change by the American Cooperative Cataract Research Group (CCRG) method. III. The association of nuclear color (sclerosis) with extent of cataract formation, age and visual acuity. Invest Ophthalmol Vis Sci 1984;25:174.
  • Chylack LT Jr, Leske MC, Sperduto R, Khu P, McCarthy D, and the LOCS Research Group. Lens opacities classification system (LOCS). Arch Ophthalmol, 1988;106:330.
  • Leske MC, Chylack LT Jr, Sperduto R, Khu P, Wu SY, McCarthy D, and the LOCS Research Group. Evaluation of a lens opacities classification system. Arch Ophthalmol, 1988;106:327.
  • Jacques PF, Hartz SH, Chylack LT Jr, McGandy RB. Antioxidant status in persons with and without senile cataract. Arch Ophthalmol, 1988;106:337-40
  • Chylack LT Jr, Leske MC, Sperduto R, McCarthy D. Progress in expanding the lens opacities classification system LOCS II. Lens Res, 1988;5:109.
  • Chylack LT Jr, Leske MC, McCarthy D, Khu P, Kashiwagi T, Sperduto R. Lens opacities classification system II (LOCS II). Arch Ophthalmol, 1989;107:991-997.
  • Jacques PF, Phillips J, Hartz S, Chylack LT Jr. Lactose intake, galactose metabolism and senile cataract. Nutrition Res 1990;10:255.
  • Jacques PF, Chylack LT Jr. Epidemiological evidence of a role of the antioxidant vitamins and carotenoids in cataract. Amer J Clin Nutr 1991;53:352S-5S.
  • Leske MC, Chylack LT Jr, Wu S-Y and the LOCS Research Group. Risk factors for cataract: The Lens Opacities Case-control Study. Arch Ophthalmol 1991;109:244-251.
  • Chylack LT Jr, Wolfe JK, Singer DM, Leske MC, Bullimore MA, Bailey IL, Friend J, McCarthy D, Wu S-Y and the LSC Study Group. The Lens Opacities Classification System , Version III (LOCS III). Arch Ophthalmol 1993;111:831-836.
  • Karbassi M, Khu PM, Singer DM, Chylack LT Jr. Evaluation of Lens Opacities Classification System III applied at the slitlamp. Optom Vis Sci 1993;70:923-928.
  • Wolfe JK, Friend J, Singer DM, Chylack LT Jr. Assessment of the ability of methods of measuring cataract to detect clinically significant change. Ophthalmol Res 1994;26(Suppl):55-60.
  • Chylack LT Jr, Wolfe JK, Friend J, Tung W, Singer DM, Brown NP, Hurst MA, Kopcke W, Schalch W. Validation of methods for the assessment of cataract progression in the Roche European-American Anticataract Trial (REACT). Ophthalmol Epidemiology 1995; 2:59-75
  • Leske MC, Chylack, LT Jr., Wu S-y, Schoenfeld A, He Q, Friend J, Wolfe J, The Longitudinal Study of Cataract Group. Incidence and progression of nuclear opacities in the Longitudinal Study of Cataract. Ophthalmology 1996;103:705-712
  • Leske MC, Chylack LT Jr, He Q, Wu S-Y, Schoenfeld E, Friend JH, Wolfe J, and the LSC Group. Incidence and progression of cortical and posterior subcapsular opacities: Longitudinal Study of Cataract. Ophthalmology 104;1987-93,1997
  • Leske MC, Chylack LT Jr, He Q, Wu S-Y, Schoenfeld E, Friend JH, Wolfe J, and the LSC Group. Antioxidant vitamins and nuclear opacities: The Longitudinal Study of Cataract. Ophthalmol. 105;831-6,1998
  • Thylefors B, Chylack, LT Jr, Konyama K, Sasaki K, Sperduto R, Taylor HR, West S. A simplified cataract grading system. The WHO Cataract Grading Group. Ophthalmic Epidemiology, 2002;9:83-95.
  • Chylack LT Jr, Brown NP, Bron A, Hurst M, Kopcke W, Thien U, Schalch W. The Roche European American Cataract Trial (REACT): a randomized clinical trial to investigate the efficacy of an oral antioxidant micronutrient mixture to slow progression of age-related cataract. Ophthalmic Epidemiology 2002;9:49-80.
  • Davison JA and Chylack LT Jr. Clinical application of the Lens Opacities Classification System III in the performance of phacoemulsification. JCRS. 2003;29:138-45.

  • Chylack LT Jr. Review of: Cataracts. The New England Journal of Medicine 1992;326:716.

  • Chylack LT Jr. Classification of human cataractous change by the American Cooperative Cataract Research Group methods. In Ciba Foundation Symposium, Vol. 106 Human Cataract Formation, (eds. Nugent J, Whelan J), 1984;3.
  • Harding CV, Chylack LT Jr, Susan SR, Decker JG, Lo WK. Morphological changes in the cataract: the ultrastructure of human lens opacities, localized by Cooperative Cataract Research Group Procedures. In Red Blood Cells and Lens Metabolism (ed. Srivastava SK), Elsevier North Holland, Inc., 1980;27.
  • Leske MC, Chylack LT Jr, Pennett M, McCarthy D, Sperduto R. Progress toward developing a cataract classification system. In Developments in Ophthalmology, Vol. 15 (ed. Straub W), Cataract Epidemiology (eds. Sasaki K, Hockwin O, Leske MC), S Karger AG, New York, 1987;9.
  • Khu PM, Chylack LT Jr. Subjective classification and objective quantitation of human cataract. In Principles and Practice of Ophthalmology, The Harvard System (eds. Albert DM, Jakobiec FA) WB Saunders Company, Philadelphia, PA, 1993 591-602.
  • Chylack LT Jr. Surgical Anatomy, Pathogenesis and Classification of Cataracts. In Cataract Surgery, A Text and Atlas (ed. Steinert RF) WB Saunders Company, Boston, 1994
  • Chylack LT Jr. Surgical Anatomy, Pathogenesis and Classification of Cataracts. In Cataract Surgery, A Text and Atlas (2nd ed. Steinert RF) WB Saunders Company, Boston, Chapter 2, 2003, pp 11-19.