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Cited by 93Spaceflight effects on biologyGlaucoma and retinal disordersRetinal Imaging and Analysis

Optical Coherence Tomography Analysis of the Optic Nerve Head and Surrounding Structures in Long-Duration International Space Station Astronauts

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Patel, Nimesh, Pass, Anastas, Mason, Sara, Gibson, Charles R., Otto, Christian·2018·JAMA Ophthalmology
DOI 10.1001/jamaophthalmol.2017.6226
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Abstract

Importance: After long-duration spaceflight, morphological changes in the optic nerve head (ONH) and surrounding tissues have been reported. Objective: To develop methods to quantify ONH and surrounding tissue changes using preflight and postflight optical coherence tomographic scans of the ONH region. Design, Setting, and Participants: Two separate analyses were done on retrospective data, with the first comparing a preflight group with a control group, followed by preflight to postflight analysis. All astronaut data were collected on the same instrument and maintained by the National Aeronautics and Space Administration (NASA) Lifetime Surveillance of Astronaut Health. Control data were all collected at the University of Houston. Participants were 15 astronauts who had previously been on an approximately 6-month long-duration mission and had associated preflight and postflight ONH scans. The control group consisted of 43 individuals with no history of ocular pathology or microgravity exposure. Development of algorithms and data analysis were performed between 2012 and 2015. Main Outcomes and Measures: The optical coherence tomography data were analyzed using custom MATLAB programs (MathWorks) in which the Bruch membrane opening (BMO) was manually delineated and used as a reference for all morphological measures. The retinal pigment epithelium (RPE) position 2 mm from the center of the BMO was used to calculate the BMO height. Global and quadrant total retinal thickness and retinal nerve fiber layer (RNFL) thickness were calculated for elliptical annular regions referenced to the BMO. The standard circumpapillary circular scan was used to quantify RNFL and choroidal thickness. Results: Among 15 astronauts (mean [SD] age at preflight evaluation, 48.7 [4.0] years) in this retrospective study, the BMO was recessed in preflight astronauts compared with healthy controls and deepened after long-duration microgravity exposure (median change, -9.9 μm; 95% CI of difference, -16.3 to 3.7 μm; P = .03). After long-duration missions, there was an increase in total retinal thickness to 1000 μm and RNFL to 500 μm from the BMO. Circumpapillary RNFL thickness increased by a median of 2.9 μm (95% CI of difference, 1.1-4.4 μm; P < .01), and there was no change in choroidal thickness (median change, 9.3 μm; 95% CI of difference, -12.1 to 19.6 μm; P = .66). Conclusions and Relevance: After long-duration microgravity exposure, there are disc edema-like changes in the morphology of the ONH and surrounding tissue. The methods developed to analyze the ONH and surrounding tissue can be useful for assessing longitudinal changes and countermeasures in astronauts, as well as potentially for terrestrial disc edema causes.

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  • A majority of long-duration astronauts, including females, present with some level of ODE and engorgement of the choroidal vasculature.

    “Through this technology, it has been recently discovered that that a majority of long-duration astronauts (including females) present with some level of ODE and engorgement of the choroidal vasculature48,55.”

    From Red risks for a journey to the red planet: The highest priority human health risks for a mission to Mars (2020) · cites this paper as [55]

    The Preflight vs Postflight OCT Analysis (page unavailable) reports choroidal folds in 11 of 15 astronauts, and the Discussion describes retinal thickening resembling mild disc edema after long-duration flight. But folds are not evidence of choroidal vascular engorgement: the paper reports no significant change in choroidal thickness. It also does not establish that a majority had optic disc edema or report the finding specifically for female astronauts. (LLM, conf=0.87)

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Authors
Patel, N., Pass, A., Mason, S., Gibson, C. R., & Otto, C.
Affiliations
  • University of Houston (US)
  • MEI Technologies (United States) (US)
  • Coastal Eye Associates, Webster, Texas
  • Universities Space Research Association (US)
Corresponding author
Patel, Nimesh
ORCID
Venue
JAMA Ophthalmology
Publisher
American Medical Association (AMA)
Published
2018-02-01
Volume
136
Issue
2
Pages
193
ISSN
2168-6165 (ISSN-L)
DOI
10.1001/jamaophthalmol.2017.6226
OpenAlex
W2783551926
Cited by
92
References
37
Citations by year
2026: 3 · 2025: 18 · 2024: 15 · 2023: 13 · 2022: 10 · 2021: 7 · 2020: 13 · 2019: 6 · 2018: 7
FWCI
5.67
Type
journal article
Language
en
Open access
Locations
  • JAMA Ophthalmology (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institutes of Health
  • National Eye Institute (P30EY007551)
Topics
  • Health Sciences › Medicine › Physiology › Spaceflight effects on biology
  • Health Sciences › Medicine › Ophthalmology › Glaucoma and retinal disorders
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal Imaging and Analysis
Keywords
optic nerve head, long-duration spaceflight, microgravity, astronauts, retinal nerve fiber layer thickness, retinal thickness, choroidal thickness, retinal pigment epithelium, optic disc morphology, International Space Station
MeSH terms
Adult, Female, Follow-Up Studies, Humans, Intraocular Pressure, Male, Middle Aged, Optic Disk, Optic Nerve Diseases, Retinal Ganglion Cells, Retrospective Studies, Space Flight, Time Factors, Weightlessness, Bruch Membrane, Disease Progression, Astronauts, Tomography, Optical Coherence

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