Abstract
Prolonged microgravity exposure during long-duration spaceflight (LDSF) produces unusual physiologic and pathologic neuro-ophthalmic findings in astronauts. These microgravity associated findings collectively define the “Spaceflight Associated Neuro-ocular Syndrome” (SANS). We compare and contrast prior published work on SANS by the National Aeronautics and Space Administration’s (NASA) Space Medicine Operations Division with retrospective and prospective studies from other research groups. In this manuscript, we update and review the clinical manifestations of SANS including: unilateral and bilateral optic disc edema, globe flattening, choroidal and retinal folds, hyperopic refractive error shifts, and focal areas of ischemic retina (i.e., cotton wool spots). We also discuss the knowledge gaps for in-flight and terrestrial human research including potential countermeasures for future study. We recommend that NASA and its research partners continue to study SANS in preparation for future longer duration manned space missions.
Highlights
Unique and distinctive clinical and imaging findings occur in astronauts both during and after short and long duration space flight (LDSF)
We describe the qualitative and comparative sensitivity and specificity of the various available tests for detecting specific signs in Space flight Associated Neuro-ocular syndrome” (SANS) and not the positive some astronauts, SANS was termed the visual impairment and intracranial pressure (VIIP) syndrome
The results of this study suggest that there may be some resolution of structural changes, there can be long-term anatomical changes after extendedduration spaceflight
Summary
Spaceflight associated neuro-ocular syndrome (SANS) and the neuro-ophthalmologic effects of microgravity: a review and an update. Prolonged microgravity exposure during long-duration spaceflight (LDSF) produces unusual physiologic and pathologic neuroophthalmic findings in astronauts These microgravity associated findings collectively define the “Spaceflight Associated Neuroocular Syndrome” (SANS). We compare and contrast prior published work on SANS by the National Aeronautics and Space Administration’s (NASA) Space Medicine Operations Division with retrospective and prospective studies from other research groups. In this manuscript, we update and review the clinical manifestations of SANS including: unilateral and bilateral optic disc edema, globe flattening, choroidal and retinal folds, hyperopic refractive error shifts, and focal areas of ischemic retina (i.e., cotton wool spots). We recommend that NASA and its research partners continue to study SANS in preparation for future longer duration manned space missions
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