Optic disc edema and chorioretinal folds develop during strict 6° head‐down tilt bed rest with or without artificial gravity
Spaceflight associated neuro‐ocular syndrome (SANS) is hypothesized to develop as a consequence of the chronic headward fluid shift that occurs in sustained weightlessness. We exposed healthy subjects (n = 24) to strict 6° head‐down tilt bed rest (HDTBR), an analog of weightlessness that generates a...
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| Published in | Physiological reports Vol. 9; no. 15; pp. e14977 - n/a |
|---|---|
| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
John Wiley & Sons, Inc
01.08.2021
John Wiley and Sons Inc Wiley |
| Subjects | |
| Online Access | Get full text |
| ISSN | 2051-817X 2051-817X |
| DOI | 10.14814/phy2.14977 |
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| Abstract | Spaceflight associated neuro‐ocular syndrome (SANS) is hypothesized to develop as a consequence of the chronic headward fluid shift that occurs in sustained weightlessness. We exposed healthy subjects (n = 24) to strict 6° head‐down tilt bed rest (HDTBR), an analog of weightlessness that generates a sustained headward fluid shift, and we monitored for ocular changes similar to findings that develop in SANS. Two‐thirds of the subjects received a daily 30‐min exposure to artificial gravity (AG, 1 g at center of mass, ~0.3 g at eye level) during HDTBR by either continuous (cAG, n = 8) or intermittent (iAG, n = 8) short‐arm centrifugation to investigate whether this intervention would attenuate headward fluid shift‐induced ocular changes. Optical coherence tomography images were acquired to quantify changes in peripapillary total retinal thickness (TRT), retinal nerve fiber layer thickness, and choroidal thickness, and to detect chorioretinal folds. Intraocular pressure (IOP), optical biometry, and standard automated perimetry data were collected. TRT increased by 35.9 µm (95% CI, 19.9–51.9 µm, p < 0.0001), 36.5 µm (95% CI, 4.7–68.2 µm, p = 0.01), and 27.6 µm (95% CI, 8.8–46.3 µm, p = 0.0005) at HDTBR day 58 in the control, cAG, and iAG groups, respectively. Chorioretinal folds developed in six subjects across the groups, despite small increases in IOP. Visual function outcomes did not change. These findings validate strict HDTBR without elevated ambient CO2 as a model for investigating SANS and suggest that a fluid shift reversal of longer duration and/or greater magnitude at the eye may be required to prevent or mitigate SANS.
Spaceflight associated neuro‐ocular syndrome (SANS) is hypothesized to develop as a consequence of the chronic headward fluid shift that occurs in sustained weightlessness. To investigate this condition, healthy subjects were exposed to strict 6º head‐down tilt bed rest (HDTBR), a spaceflight analog that causes a chronic headward fluid shift and can lead to the development of optic disc edema in some participants. For the first time, we demonstrate that chorioretinal folds develop during HDTBR, along with signs of optic disc edema, similar to findings that occur in astronauts during spaceflight. However, ocular changes were not mitigated in subjects who were exposed for 30 min per day to continuous or intermittent artificial gravity (AG) via centrifugation during HDTBR. These findings validate strict HDTBR without elevated ambient CO2 as a model for investigating these ocular changes and suggest that a fluid shift reversal of longer duration and/or greater magnitude at the eye than used here may be required to prevent or mitigate spaceflight associated neuro‐ocular syndrome findings. |
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| AbstractList | Abstract Spaceflight associated neuro‐ocular syndrome (SANS) is hypothesized to develop as a consequence of the chronic headward fluid shift that occurs in sustained weightlessness. We exposed healthy subjects (n = 24) to strict 6° head‐down tilt bed rest (HDTBR), an analog of weightlessness that generates a sustained headward fluid shift, and we monitored for ocular changes similar to findings that develop in SANS. Two‐thirds of the subjects received a daily 30‐min exposure to artificial gravity (AG, 1 g at center of mass, ~0.3 g at eye level) during HDTBR by either continuous (cAG, n = 8) or intermittent (iAG, n = 8) short‐arm centrifugation to investigate whether this intervention would attenuate headward fluid shift‐induced ocular changes. Optical coherence tomography images were acquired to quantify changes in peripapillary total retinal thickness (TRT), retinal nerve fiber layer thickness, and choroidal thickness, and to detect chorioretinal folds. Intraocular pressure (IOP), optical biometry, and standard automated perimetry data were collected. TRT increased by 35.9 µm (95% CI, 19.9–51.9 µm, p < 0.0001), 36.5 µm (95% CI, 4.7–68.2 µm, p = 0.01), and 27.6 µm (95% CI, 8.8–46.3 µm, p = 0.0005) at HDTBR day 58 in the control, cAG, and iAG groups, respectively. Chorioretinal folds developed in six subjects across the groups, despite small increases in IOP. Visual function outcomes did not change. These findings validate strict HDTBR without elevated ambient CO2 as a model for investigating SANS and suggest that a fluid shift reversal of longer duration and/or greater magnitude at the eye may be required to prevent or mitigate SANS. Spaceflight associated neuro‐ocular syndrome (SANS) is hypothesized to develop as a consequence of the chronic headward fluid shift that occurs in sustained weightlessness. We exposed healthy subjects (n = 24) to strict 6° head‐down tilt bed rest (HDTBR), an analog of weightlessness that generates a sustained headward fluid shift, and we monitored for ocular changes similar to findings that develop in SANS. Two‐thirds of the subjects received a daily 30‐min exposure to artificial gravity (AG, 1 g at center of mass, ~0.3 g at eye level) during HDTBR by either continuous (cAG, n = 8) or intermittent (iAG, n = 8) short‐arm centrifugation to investigate whether this intervention would attenuate headward fluid shift‐induced ocular changes. Optical coherence tomography images were acquired to quantify changes in peripapillary total retinal thickness (TRT), retinal nerve fiber layer thickness, and choroidal thickness, and to detect chorioretinal folds. Intraocular pressure (IOP), optical biometry, and standard automated perimetry data were collected. TRT increased by 35.9 µm (95% CI, 19.9–51.9 µm, p < 0.0001), 36.5 µm (95% CI, 4.7–68.2 µm, p = 0.01), and 27.6 µm (95% CI, 8.8–46.3 µm, p = 0.0005) at HDTBR day 58 in the control, cAG, and iAG groups, respectively. Chorioretinal folds developed in six subjects across the groups, despite small increases in IOP. Visual function outcomes did not change. These findings validate strict HDTBR without elevated ambient CO2 as a model for investigating SANS and suggest that a fluid shift reversal of longer duration and/or greater magnitude at the eye may be required to prevent or mitigate SANS. Spaceflight associated neuro‐ocular syndrome (SANS) is hypothesized to develop as a consequence of the chronic headward fluid shift that occurs in sustained weightlessness. To investigate this condition, healthy subjects were exposed to strict 6º head‐down tilt bed rest (HDTBR), a spaceflight analog that causes a chronic headward fluid shift and can lead to the development of optic disc edema in some participants. For the first time, we demonstrate that chorioretinal folds develop during HDTBR, along with signs of optic disc edema, similar to findings that occur in astronauts during spaceflight. However, ocular changes were not mitigated in subjects who were exposed for 30 min per day to continuous or intermittent artificial gravity (AG) via centrifugation during HDTBR. These findings validate strict HDTBR without elevated ambient CO2 as a model for investigating these ocular changes and suggest that a fluid shift reversal of longer duration and/or greater magnitude at the eye than used here may be required to prevent or mitigate spaceflight associated neuro‐ocular syndrome findings. Spaceflight associated neuro-ocular syndrome (SANS) is hypothesized to develop as a consequence of the chronic headward fluid shift that occurs in sustained weightlessness. We exposed healthy subjects (n = 24) to strict 6° head-down tilt bed rest (HDTBR), an analog of weightlessness that generates a sustained headward fluid shift, and we monitored for ocular changes similar to findings that develop in SANS. Two-thirds of the subjects received a daily 30-min exposure to artificial gravity (AG, 1 g at center of mass, ~0.3 g at eye level) during HDTBR by either continuous (cAG, n = 8) or intermittent (iAG, n = 8) short-arm centrifugation to investigate whether this intervention would attenuate headward fluid shift-induced ocular changes. Optical coherence tomography images were acquired to quantify changes in peripapillary total retinal thickness (TRT), retinal nerve fiber layer thickness, and choroidal thickness, and to detect chorioretinal folds. Intraocular pressure (IOP), optical biometry, and standard automated perimetry data were collected. TRT increased by 35.9 µm (95% CI, 19.9-51.9 µm, p < 0.0001), 36.5 µm (95% CI, 4.7-68.2 µm, p = 0.01), and 27.6 µm (95% CI, 8.8-46.3 µm, p = 0.0005) at HDTBR day 58 in the control, cAG, and iAG groups, respectively. Chorioretinal folds developed in six subjects across the groups, despite small increases in IOP. Visual function outcomes did not change. These findings validate strict HDTBR without elevated ambient CO as a model for investigating SANS and suggest that a fluid shift reversal of longer duration and/or greater magnitude at the eye may be required to prevent or mitigate SANS. Spaceflight associated neuro‐ocular syndrome (SANS) is hypothesized to develop as a consequence of the chronic headward fluid shift that occurs in sustained weightlessness. We exposed healthy subjects ( n = 24) to strict 6° head‐down tilt bed rest (HDTBR), an analog of weightlessness that generates a sustained headward fluid shift, and we monitored for ocular changes similar to findings that develop in SANS. Two‐thirds of the subjects received a daily 30‐min exposure to artificial gravity (AG, 1 g at center of mass, ~0.3 g at eye level) during HDTBR by either continuous (cAG, n = 8) or intermittent (iAG, n = 8) short‐arm centrifugation to investigate whether this intervention would attenuate headward fluid shift‐induced ocular changes. Optical coherence tomography images were acquired to quantify changes in peripapillary total retinal thickness (TRT), retinal nerve fiber layer thickness, and choroidal thickness, and to detect chorioretinal folds. Intraocular pressure (IOP), optical biometry, and standard automated perimetry data were collected. TRT increased by 35.9 µm (95% CI, 19.9–51.9 µm, p < 0.0001), 36.5 µm (95% CI, 4.7–68.2 µm, p = 0.01), and 27.6 µm (95% CI, 8.8–46.3 µm, p = 0.0005) at HDTBR day 58 in the control, cAG, and iAG groups, respectively. Chorioretinal folds developed in six subjects across the groups, despite small increases in IOP. Visual function outcomes did not change. These findings validate strict HDTBR without elevated ambient CO 2 as a model for investigating SANS and suggest that a fluid shift reversal of longer duration and/or greater magnitude at the eye may be required to prevent or mitigate SANS. Spaceflight associated neuro‐ocular syndrome (SANS) is hypothesized to develop as a consequence of the chronic headward fluid shift that occurs in sustained weightlessness. To investigate this condition, healthy subjects were exposed to strict 6º head‐down tilt bed rest (HDTBR), a spaceflight analog that causes a chronic headward fluid shift and can lead to the development of optic disc edema in some participants. For the first time, we demonstrate that chorioretinal folds develop during HDTBR, along with signs of optic disc edema, similar to findings that occur in astronauts during spaceflight. However, ocular changes were not mitigated in subjects who were exposed for 30 min per day to continuous or intermittent artificial gravity (AG) via centrifugation during HDTBR. These findings validate strict HDTBR without elevated ambient CO 2 as a model for investigating these ocular changes and suggest that a fluid shift reversal of longer duration and/or greater magnitude at the eye than used here may be required to prevent or mitigate spaceflight associated neuro‐ocular syndrome findings. Spaceflight associated neuro-ocular syndrome (SANS) is hypothesized to develop as a consequence of the chronic headward fluid shift that occurs in sustained weightlessness. We exposed healthy subjects (n = 24) to strict 6° head-down tilt bed rest (HDTBR), an analog of weightlessness that generates a sustained headward fluid shift, and we monitored for ocular changes similar to findings that develop in SANS. Two-thirds of the subjects received a daily 30-min exposure to artificial gravity (AG, 1 g at center of mass, ~0.3 g at eye level) during HDTBR by either continuous (cAG, n = 8) or intermittent (iAG, n = 8) short-arm centrifugation to investigate whether this intervention would attenuate headward fluid shift-induced ocular changes. Optical coherence tomography images were acquired to quantify changes in peripapillary total retinal thickness (TRT), retinal nerve fiber layer thickness, and choroidal thickness, and to detect chorioretinal folds. Intraocular pressure (IOP), optical biometry, and standard automated perimetry data were collected. TRT increased by 35.9 µm (95% CI, 19.9-51.9 µm, p < 0.0001), 36.5 µm (95% CI, 4.7-68.2 µm, p = 0.01), and 27.6 µm (95% CI, 8.8-46.3 µm, p = 0.0005) at HDTBR day 58 in the control, cAG, and iAG groups, respectively. Chorioretinal folds developed in six subjects across the groups, despite small increases in IOP. Visual function outcomes did not change. These findings validate strict HDTBR without elevated ambient CO2 as a model for investigating SANS and suggest that a fluid shift reversal of longer duration and/or greater magnitude at the eye may be required to prevent or mitigate SANS.Spaceflight associated neuro-ocular syndrome (SANS) is hypothesized to develop as a consequence of the chronic headward fluid shift that occurs in sustained weightlessness. We exposed healthy subjects (n = 24) to strict 6° head-down tilt bed rest (HDTBR), an analog of weightlessness that generates a sustained headward fluid shift, and we monitored for ocular changes similar to findings that develop in SANS. Two-thirds of the subjects received a daily 30-min exposure to artificial gravity (AG, 1 g at center of mass, ~0.3 g at eye level) during HDTBR by either continuous (cAG, n = 8) or intermittent (iAG, n = 8) short-arm centrifugation to investigate whether this intervention would attenuate headward fluid shift-induced ocular changes. Optical coherence tomography images were acquired to quantify changes in peripapillary total retinal thickness (TRT), retinal nerve fiber layer thickness, and choroidal thickness, and to detect chorioretinal folds. Intraocular pressure (IOP), optical biometry, and standard automated perimetry data were collected. TRT increased by 35.9 µm (95% CI, 19.9-51.9 µm, p < 0.0001), 36.5 µm (95% CI, 4.7-68.2 µm, p = 0.01), and 27.6 µm (95% CI, 8.8-46.3 µm, p = 0.0005) at HDTBR day 58 in the control, cAG, and iAG groups, respectively. Chorioretinal folds developed in six subjects across the groups, despite small increases in IOP. Visual function outcomes did not change. These findings validate strict HDTBR without elevated ambient CO2 as a model for investigating SANS and suggest that a fluid shift reversal of longer duration and/or greater magnitude at the eye may be required to prevent or mitigate SANS. Spaceflight associated neuro‐ocular syndrome (SANS) is hypothesized to develop as a consequence of the chronic headward fluid shift that occurs in sustained weightlessness. We exposed healthy subjects (n = 24) to strict 6° head‐down tilt bed rest (HDTBR), an analog of weightlessness that generates a sustained headward fluid shift, and we monitored for ocular changes similar to findings that develop in SANS. Two‐thirds of the subjects received a daily 30‐min exposure to artificial gravity (AG, 1 g at center of mass, ~0.3 g at eye level) during HDTBR by either continuous (cAG, n = 8) or intermittent (iAG, n = 8) short‐arm centrifugation to investigate whether this intervention would attenuate headward fluid shift‐induced ocular changes. Optical coherence tomography images were acquired to quantify changes in peripapillary total retinal thickness (TRT), retinal nerve fiber layer thickness, and choroidal thickness, and to detect chorioretinal folds. Intraocular pressure (IOP), optical biometry, and standard automated perimetry data were collected. TRT increased by 35.9 µm (95% CI, 19.9–51.9 µm, p < 0.0001), 36.5 µm (95% CI, 4.7–68.2 µm, p = 0.01), and 27.6 µm (95% CI, 8.8–46.3 µm, p = 0.0005) at HDTBR day 58 in the control, cAG, and iAG groups, respectively. Chorioretinal folds developed in six subjects across the groups, despite small increases in IOP. Visual function outcomes did not change. These findings validate strict HDTBR without elevated ambient CO2 as a model for investigating SANS and suggest that a fluid shift reversal of longer duration and/or greater magnitude at the eye may be required to prevent or mitigate SANS. |
| Author | Lee, Stuart M. C. Macias, Brandon R. Sangi‐Haghpeykar, Haleh Laurie, Steven S. Pardon, Laura P. Marshall‐Goebel, Karina Gupta, Akash Bershad, Eric M. Stern, Claudia Greenwald, Scott H. |
| AuthorAffiliation | 1 KBR Houston TX USA 7 Department of Neurosurgery Baylor College of Medicine Houston TX USA 3 Institute of Aerospace Medicine German Aerospace Center Clinical Aerospace Medicine Cologne Germany 4 Department of Obstetrics and Gynecology Baylor College of Medicine Houston TX USA 5 NASA Johnson Space Center Houston TX USA 2 Center for Space Medicine Baylor College of Medicine Houston TX USA 6 Department of Neurology Baylor College of Medicine Houston TX USA |
| AuthorAffiliation_xml | – name: 7 Department of Neurosurgery Baylor College of Medicine Houston TX USA – name: 4 Department of Obstetrics and Gynecology Baylor College of Medicine Houston TX USA – name: 6 Department of Neurology Baylor College of Medicine Houston TX USA – name: 2 Center for Space Medicine Baylor College of Medicine Houston TX USA – name: 1 KBR Houston TX USA – name: 3 Institute of Aerospace Medicine German Aerospace Center Clinical Aerospace Medicine Cologne Germany – name: 5 NASA Johnson Space Center Houston TX USA |
| Author_xml | – sequence: 1 givenname: Steven S. orcidid: 0000-0002-8794-3583 surname: Laurie fullname: Laurie, Steven S. email: steven.laurie@nasa.gov organization: KBR – sequence: 2 givenname: Scott H. surname: Greenwald fullname: Greenwald, Scott H. organization: KBR – sequence: 3 givenname: Karina surname: Marshall‐Goebel fullname: Marshall‐Goebel, Karina organization: KBR – sequence: 4 givenname: Laura P. surname: Pardon fullname: Pardon, Laura P. organization: KBR – sequence: 5 givenname: Akash surname: Gupta fullname: Gupta, Akash organization: Baylor College of Medicine – sequence: 6 givenname: Stuart M. C. surname: Lee fullname: Lee, Stuart M. C. organization: KBR – sequence: 7 givenname: Claudia surname: Stern fullname: Stern, Claudia organization: Clinical Aerospace Medicine – sequence: 8 givenname: Haleh surname: Sangi‐Haghpeykar fullname: Sangi‐Haghpeykar, Haleh organization: Baylor College of Medicine – sequence: 9 givenname: Brandon R. surname: Macias fullname: Macias, Brandon R. organization: NASA Johnson Space Center – sequence: 10 givenname: Eric M. surname: Bershad fullname: Bershad, Eric M. organization: Baylor College of Medicine |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/34355874$$D View this record in MEDLINE/PubMed |
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| Keywords | spaceflight analog bed rest chorioretinal folds artificial gravity retinal thickness spaceflight associated neuro-ocular syndrome centrifugation |
| Language | English |
| License | Attribution http://creativecommons.org/licenses/by/4.0 http://doi.wiley.com/10.1002/tdm_license_1.1 2021 The Authors. Physiological Reports published by Wiley Periodicals LLC on behalf of The Physiological Society and the American Physiological Society. This article has been contributed to by US Government employees and their work is in the public domain in the USA. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
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| Notes | Funding information National Aeronautics and Space Administration Human Research Program Grant #NNJ15ZSA001N‐AGBR: Studying the Physiological and Anatomical Cerebral Effects of Centrifugation and Head‐Down Tilt Bed Rest (SPACE‐CENT) (EMB). Any opinions, findings, and conclusions or recommendations expressed in this article are those of the authors and do not necessarily reflect the views of the National Aeronautics and Space Administration. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 |
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| Snippet | Spaceflight associated neuro‐ocular syndrome (SANS) is hypothesized to develop as a consequence of the chronic headward fluid shift that occurs in sustained... Spaceflight associated neuro-ocular syndrome (SANS) is hypothesized to develop as a consequence of the chronic headward fluid shift that occurs in sustained... Abstract Spaceflight associated neuro‐ocular syndrome (SANS) is hypothesized to develop as a consequence of the chronic headward fluid shift that occurs in... |
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| SubjectTerms | Adult artificial gravity Astronauts Automation bed rest Bed Rest - adverse effects Biometrics Body mass index Carbon dioxide Case-Control Studies Centrifugation chorioretinal folds Choroid Diseases - etiology Choroid Diseases - pathology Data collection Edema Female Head-Down Tilt - adverse effects Humans Immobilization Male Optics Original Papilledema - etiology Papilledema - pathology Physiology Retina Retinal Diseases - etiology Retinal Diseases - pathology retinal thickness Software Space flight spaceflight analog spaceflight associated neuro‐ocular syndrome Trinucleotide repeats Values Visual perception Weightlessness Weightlessness Simulation - adverse effects |
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| Title | Optic disc edema and chorioretinal folds develop during strict 6° head‐down tilt bed rest with or without artificial gravity |
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