Menu

 

Task Book: Biological & Physical Sciences Division and Human Research Program
Advanced Search     

Project Title:  Prospective Observational Study of Ocular Health in ISS Crews (PI=Macias) Reduce
Fiscal Year: FY 2020 
Division: Human Research 
Research Discipline/Element:
HRP HHC:Human Health Countermeasures
Start Date: 01/06/2017  
End Date: 10/01/2019  
Task Last Updated: 12/09/2019 
Download report in PDF pdf
Principal Investigator/Affiliation:   Macias, Brandon  Ph.D. / NASA Johnson Space Center 
Address:  Johnson Space Center Cardiovascular and Vision Laboratory 
2101 NASA Parkway, HAC/B21N-1207 
Houston , TX 77058 
Email: brandon.r.macias@nasa.gov 
Phone: 281-483-2026  
Congressional District: 36 
Web:  
Organization Type: NASA CENTER 
Organization Name: NASA Johnson Space Center 
Joint Agency:  
Comments: NOTE: Became civil servant fall 2020; previously KBR/NASA Johnson Space Center. Prior to that until 2016, was at the University of California, San Diego. 
Co-Investigator(s)
Affiliation: 
Gibson, C. Robert  O.D. Coastal Eye Associates--Texas 
Sargsyan, Ashot  M.D. KBRwyle, Houston, TX 
Alexander, David  M.D. NASA Johnson Space Center 
Ploutz-Snyder, Robert  Ph.D. University of Michigan 
Riascos-Castaneda, Roy  M.D. University of Texas Medical Branch 
Patel, Nimish  O.D., Ph.D. University of Houston 
Samuels, Brian  M.D., Ph.D. University of Alabama at Birmingham 
Kramer, Larry  M.D. The University of Texas 
Lee, Stuart  Ph.D. KBR/NASA Johnson Space Center 
Stenger, Michael  NASA Johnson Space Center 
Key Personnel Changes / Previous PI: Current PI: Brandon R. Macias; Former PI: Christian Otto.
Project Information: Grant/Contract No. Directed Research 
Responsible Center: NASA JSC 
Grant Monitor: Norsk, Peter  
Center Contact:  
Peter.norsk@nasa.gov 
Solicitation / Funding Source: Directed Research 
Grant/Contract No.: Directed Research 
Project Type: FLIGHT 
Flight Program: ISS 
TechPort: No 
No. of Post Docs:  
No. of PhD Candidates:  
No. of Master's Candidates:
No. of Bachelor's Candidates:  
No. of PhD Degrees:
No. of Master's Degrees:
No. of Bachelor's Degrees:  
Human Research Program Elements: (1) HHC:Human Health Countermeasures
Human Research Program Risks: (1) SANS:Risk of Spaceflight Associated Neuro-ocular Syndrome (IRP Rev I)
Human Research Program Gaps: (1) SANS01:We do not know the etiological mechanisms and contributing risk factors for ocular structural and functional changes seen in-flight and postflight (IRP Rev I)
Flight Assignment/Project Notes: NOTE: Used 10/1/2019 as end date for reporting purposes (Ed., 12/11/2019)

NOTE: End date changed to 9/30/2019 (original end date was 11/16/2017) per PI (Ed., 10/9/18)

NOTE: End date changed to 9/30/2018 (original end date was 11/16/2017) per A. Allcorn and PI (Ed., 10/11/17)

Task Description: NOTE: Continuation of "Prospective Observational Study of Ocular Health in ISS Crews" with Dr. Brandon Macias as new Principal Investigator (PI). Former PI was Dr. Christian Otto, who moved in January 2017.

Spaceflight-associated neuro-ocular syndrome (SANS) is characterized by changes in astronauts’ vision (hyperopic shifts) and eye structure (optic disc edema, choroidal folds, globe flattening, and cotton wool spots). This risk is termed Spaceflight Associated Neuro-ocular Syndrome (SANS), formally called Visual Impairment/Intracranial Pressure (VIIP), by NASA. The purpose of this study is to characterize and quantify the ocular, neurological, and cardiovascular changes associated with the development of SANS before, during, and after long-duration International Space Station (ISS) missions. The data collected will augment Medical Requirements Integration Documents (MRID) requirements and testing performed during scheduled exams. In addition, the frequency of in-flight and postflight testing will be increased to quantify the temporal profile of our outcome measures. In short, preflight, in-flight, and postflight measures include: tonometry, ocular ultrasound, brain blood flow, fundoscopy, visual acuity, OCT; while brain and ocular magnetic resonance imaging (MRI), and eye exams including fundus exams and cycloplegic refraction will be conducted preflight and postflight. Moreover, blood pressure and cardiac output will be collected preflight, in-flight, and postflight to assess systemic vascular compliance.

Expected Outcomes

1. Significant in-flight change in at least one or more of the following variables will occur: visual acuity, intraocular pressure, optic disc edema (papilledema), chorioretinal folds, optic nerve sheath distention, optic nerve tortuosity, optic nerve-to-sheath ratio, globe flattening, and retinal “cotton-wool spots.” In addition, these variables will return to pre-flight values during the postflight recovery period.

2. It is expected that if an in-flight or postflight measure deviates from preflight baseline measures, it may have a prolonged recovery to baseline (preflight values) that is positively associated with severity.

Specific Aims

Characterize the temporal profile of ocular, neurological, and cardiovascular variables associated with the development of SANS before, during, and after long-duration ISS missions.

See also: https://www.nasa.gov/mission_pages/station/research/experiments/explorer/Investigation.html?#id=197

Rationale for HRP Directed Research: This research is directed because it contains highly constrained research and there is insufficient time. This research is highly constrained because it is proposing additional data collections of MRID measures pre-, in-, and postflight. Since the co-investigative team collects the MRID data, they are the best source to collect this data as well. Due to the visibility of this risk, there is pressure to characterize the visual changes associated with spaceflight in order to begin to identify the underlying cause. The results of this study will help define and frame the new Risk of Microgravity-Induced Visual Impairment/Intracranial Pressure.

Research Impact/Earth Benefits: Terrestrial Benefits:

1. Advances in the tools and techniques as part of this SANS research will benefit terrestrial clinical populations.

2. Identifying the cause(s) and risk factors for the SANS syndrome will also inform the cause(s) and risk factors for these terrestrial conditions.

Task Progress & Bibliography Information FY2020 
Task Progress: We have made significant progress over the review period. We have updated and maintained our “Ocular Health” NASA IRB (Institutional Review Board) documents. Thirteen ISS crewmembers participated in the inflight medical surveillance exams and the additional testing specific to this experiment, including the One-Year mission crewmembers. All data collection is complete. Pre- and postflight evaluations included functional eye measures (cycloplegic refraction and visual fields); structural eye measures (fundoscopy, optical coherence tomography [OCT], ocular ultrasound, and optical biometry); intraocular pressure (IOP, tonometry); cardiovascular function (via ultrasound with concurrent ECG and blood pressure); blood flow velocity in the middle cerebral artery (MCA) (including an estimate of noninvasive intracranial pressure measured with transcranial Doppler); and magnetic resonance imaging (MRI) to assess eye and optic nerve structure and cerebrospinal fluid flow. In-flight measures included visual acuity, amsler grid, IOP, OCT imaging of the posterior eye, fundoscopy, ocular ultrasound, cardiovascular function, and blood flow velocity in the MCA. The primary data analysis is complete.

Detailed analysis of key variables that demonstrate significant spaceflight induced changes is complete. Currently, we have two manuscripts in review, and two others in submission for peer-reviewed journals. Preliminary results were recently reported by Dr. Macias at the 2019 Human Research Program (HRP) Workshop.

Bibliography Type: Description: (Last Updated: 12/13/2021)  Show Cumulative Bibliography Listing
 
Abstracts for Journals and Proceedings Macias B, Otto C, Ploutz-Snyder R, Sargsyan A, Alexander D, Kramer L, Riascos R, Samuels B, Gibson C, Patel N, Lee S, Laurie S, Stenger M. "Prospective Observational Study of Ocular Health in ISS Crews – The Ocular Health Study." 2019 NASA Human Research Program Investigators’ Workshop, Galveston, TX, January 22-25, 2019.

Abstracts. 2019 NASA Human Research Program Investigators’ Workshop, Galveston, TX, January 22-25, 2019. , Jan-2019

Abstracts for Journals and Proceedings Macias BR, Laurie S, Lee SMC, Marshall-Goebel K, Ploutz-Snyder R, Martin D, Hargens A, Dulchavsky S, Stenger MB. "Spaceflight Associated Neuro-ocular Syndrome: ISS vs Analog." 40th International Society for Gravitational Physiology (ISGP) Meeting, Nagoya, Japan, May 26-31, 2019.

Abstracts. 40th International Society for Gravitational Physiology (ISGP) Meeting, Nagoya, Japan, May 26-31, 2019. , May-2019

Abstracts for Journals and Proceedings Kramer LA, Hasan KM, Stenger MB, Otto C, Ploutz-Snyder RJ, Riascos RF, Macias BR. "Longitudinal study of microgravity-induced changes in brain volumetry, pituitary morphology and cerebral spinal fluid hydrodynamics: relationship to spaceflight associated neuro-ocular syndrome." International Society for Magnetic Resonance in Medicine ISMRM 27th Annual Meeting, Montreal, Canada, May 11-16, 2019.

Abstracts. International Society for Magnetic Resonance in Medicine ISMRM 27th Annual Meeting, Montreal, Canada, May 11-16, 2019. , May-2019

Articles in Peer-reviewed Journals Macias BR, Patel NB, Gibson CR, Samuels BC, Laurie SS, Otto C, Ferguson CR, Lee SMC, Ploutz-Snyder R, Kramer LA, Mader TH, Brunstetter T, Stenger MB. "Association of long-duration spaceflight with anterior and posterior ocular structure changes in astronauts and their recovery." JAMA Ophthalmol. 2020 May;138(5):553-9. https://doi.org/10.1001/jamaophthalmol.2020.0673 ; PMID: 32239198; PMCID: PMC7118682 , May-2020
Articles in Peer-reviewed Journals Kramer LA, Hasan KM, Stenger MB, Sargsyan A, Laurie SS, Otto C, Ploutz-Snyder RJ, Marshall-Goebel K, Riascos RF, Macias BR. "Intracranial effects of microgravity: A prospective longitudinal MRI study." Radiology. 2020 Jun;295(3):640-8. https://doi.org/10.1148/radiol.2020191413 ; PMID: 32286194 , Jun-2020
Articles in Peer-reviewed Journals Rohr JJ, Sater S, Sass AM, Marshall-Goebel K, Ploutz-Snyder RJ, Ethier CR, Stenger MB, Martin BA, Macias BR. "Quantitative magnetic resonance image assessment of the optic nerve and surrounding sheath after spaceflight." npj Microgravity. 2020 Oct 8;6(1):30. https://doi.org/10.1038/s41526-020-00119-3 ; PMID: 33083526; PMCID: PMC7545196 , Oct-2020
Articles in Peer-reviewed Journals Sater SH, Sass AM, Rohr JJ, Marshall-Goebel K, Ploutz-Snyder RJ, Ethier CR, Stenger MB, Kramer LA, Martin BA, Macias BR. "Automated MRI-based quantification of posterior ocular globe flattening and recovery after long-duration spaceflight." Eye (Lond). Published: 29 January 2021. https://doi.org/10.1038/s41433-021-01408-1 ; PMID: 33514895 , Jan-2021
Articles in Peer-reviewed Journals Macias BR, Ferguson CR, Patel N, Gibson C, Samuels BC, Laurie SS, Lee SMC, Ploutz-Snyder R, Kramer L, Mader TH, Brunstetter T, Alferova IV, Hargens AR, Ebert DJ, Dulchavsky SA, Stenger MB. "Changes in the optic nerve head and choroid over 1 year of spaceflight." JAMA Ophthalmol. 2021 Jun;139(6):663-7. https://doi.org/10.1001/jamaophthalmol.2021.0931 ; PMID: 33914020; PMCID: PMC8085766 , Jun-2021
Articles in Peer-reviewed Journals Marshall-Goebel K, Macias BR, Kramer LA, Hasan KM, Ferguson C, Patel N, Ploutz-Snyder RJ, Lee SMC, Ebert D, Sargsyan A, Dulchavsky S, Hargens AR, Stenger MB, Laurie S. "Association of structural changes in the brain and retina after long-duration spaceflight." JAMA Ophthalmol. 2021 Jul 1;139(7):781-4. https://doi.org/10.1001/jamaophthalmol.2021.1400 ; PMID: 34014272; PMCID: PMC8138750 , Jul-2021
Project Title:  Prospective Observational Study of Ocular Health in ISS Crews (PI=Macias) Reduce
Fiscal Year: FY 2019 
Division: Human Research 
Research Discipline/Element:
HRP HHC:Human Health Countermeasures
Start Date: 01/06/2017  
End Date: 10/01/2019  
Task Last Updated: 01/16/2019 
Download report in PDF pdf
Principal Investigator/Affiliation:   Macias, Brandon  Ph.D. / NASA Johnson Space Center 
Address:  Johnson Space Center Cardiovascular and Vision Laboratory 
2101 NASA Parkway, HAC/B21N-1207 
Houston , TX 77058 
Email: brandon.r.macias@nasa.gov 
Phone: 281-483-2026  
Congressional District: 36 
Web:  
Organization Type: NASA CENTER 
Organization Name: NASA Johnson Space Center 
Joint Agency:  
Comments: NOTE: Became civil servant fall 2020; previously KBR/NASA Johnson Space Center. Prior to that until 2016, was at the University of California, San Diego. 
Co-Investigator(s)
Affiliation: 
Gibson, C. Robert  O.D. Coastal Eye Associates--Texas 
Sargsyan, Ashot  M.D. KBRwyle, Houston, TX 
Alexander, David  M.D. NASA Johnson Space Center 
Ploutz-Snyder, Robert  Ph.D. University of Michigan 
Riascos-Castaneda, Roy  M.D. University of Texas Medical Branch 
Patel, Nimish  O.D., Ph.D. University of Houston 
Samuels, Brian  M.D., Ph.D. University of Alabama at Birmingham 
Kramer, Larry  M.D. The University of Texas 
Lee, Stuart  Ph.D. Wyle Integrated Science and Engineering/NASA Johnson Space Center 
Stenger, Michael  NASA Johnson Space Center 
Key Personnel Changes / Previous PI: Current PI: Brandon R. Macias ; Former PI: Christian Otto. January 2019 report: Dr. Michael Stenger was added as a co-investigator for his expertise in the area of Spaceflight Associated Neuro-ocular Syndrome (SANS).
Project Information: Grant/Contract No. Directed Research 
Responsible Center: NASA JSC 
Grant Monitor: Norsk, Peter  
Center Contact:  
Peter.norsk@nasa.gov 
Solicitation / Funding Source: Directed Research 
Grant/Contract No.: Directed Research 
Project Type: FLIGHT 
Flight Program: ISS 
TechPort: No 
No. of Post Docs:  
No. of PhD Candidates:  
No. of Master's Candidates:
No. of Bachelor's Candidates:  
No. of PhD Degrees:  
No. of Master's Degrees:  
No. of Bachelor's Degrees:  
Human Research Program Elements: (1) HHC:Human Health Countermeasures
Human Research Program Risks: (1) SANS:Risk of Spaceflight Associated Neuro-ocular Syndrome (IRP Rev I)
Human Research Program Gaps: (1) SANS01:We do not know the etiological mechanisms and contributing risk factors for ocular structural and functional changes seen in-flight and postflight (IRP Rev I)
Flight Assignment/Project Notes: NOTE: End date changed to 9/30/2019 (original end date was 11/16/2017) per PI (Ed., 10/9/18)

NOTE: End date changed to 9/30/2018 (original end date was 11/16/2017) per A. Allcorn and PI (Ed., 10/11/17)

Task Description: NOTE: Continuation of "Prospective Observational Study of Ocular Health in ISS Crews" with new Principal Investigator Dr. Brandon Macias. Previous PI was Dr. Christian Otto, who moved in January 2017.

Spaceflight-associated neuro-ocular syndrome (SANS) is characterized by changes in astronauts’ vision (hyperopic shifts) and eye structure (optic disc edema, choroidal folds, globe flattening, and cotton wool spots). This risk is termed Spaceflight Associated Neuro-ocular Syndrome (SANS), formally called Visual Impairment/Intracranial Pressure (VIIP), by NASA. The purpose of this study is to characterize and quantify the ocular, neurological, and cardiovascular changes associated with the development of SANS before, during, and after long-duration International Space Station (ISS) missions. The data collected will augment Medical Requirements Integration Documents (MRID) requirements and testing performed during scheduled exams. In addition, the frequency of in-flight and postflight testing will be increased to quantify the temporal profile of our outcome measures. In short, preflight, in-flight, and postflight measures include: tonometry, ocular ultrasound, brain blood flow, fundoscopy, visual acuity, OCT; while brain and ocular magnetic resonance imaging (MRI), and eye exams including fundus exams and cycloplegic refraction will be conducted preflight and postflight. Moreover, blood pressure and cardiac output will be collected preflight, in-flight, and postflight to assess systemic vascular compliance.

Expected Outcomes

1. Significant in-flight change in at least one or more of the following variables will occur: visual acuity, intraocular pressure, optic disc edema (papilledema), chorioretinal folds, optic nerve sheath distention, optic nerve tortuosity, optic nerve-to-sheath ratio, globe flattening, and retinal “cotton-wool spots.” In addition, these variables will return to pre-flight values during the postflight recovery period.

2. It is expected that if an in-flight or postflight measure deviates from preflight baseline measures, it may have a prolonged recovery to baseline (preflight values) that is positively associated with severity.

Specific Aims

Characterize the temporal profile of ocular, neurological, and cardiovascular variables associated with the development of SANS before, during, and after long-duration ISS missions.

See also: http://www.nasa.gov/mission_pages/station/research/experiments/204.html

Rationale for HRP Directed Research: This research is directed because it contains highly constrained research and there is insufficient time. This research is highly constrained because it is proposing additional data collections of MRID measures pre-, in-, and postflight. Since the co-investigative team collects the MRID data, they are the best source to collect this data as well. Due to the visibility of this risk, there is pressure to characterize the visual changes associated with spaceflight in order to begin to identify the underlying cause. The results of this study will help define and frame the new Risk of Microgravity-Induced Visual Impairment/Intracranial Pressure.

Research Impact/Earth Benefits: Terrestrial Benefits:

1. Advances in the tools and techniques as part of this SANS research will benefit terrestrial clinical populations.

2. Identifying the cause(s) and risk factors for the SANS syndrome will also inform the cause(s) and risk factors for these terrestrial conditions.

Task Progress & Bibliography Information FY2019 
Task Progress: We have made significant progress over the review period. We have updated and maintained our “Ocular Health” NASA IRB (Institutional Review Board) documents. Thirteen ISS crewmembers participated in the inflight medical surveillance exams and the additional testing specific to this experiment, including the One-Year mission crewmembers. All data collection is complete. Pre- and postflight evaluations included functional eye measures (cycloplegic refraction and visual fields); structural eye measures (fundoscopy, optical coherence tomography [OCT], ocular ultrasound, and optical biometry); intraocular pressure (IOP, tonometry); cardiovascular function (via ultrasound with concurrent ECG and blood pressure); blood flow velocity in the middle cerebral artery (MCA) (including an estimate of noninvasive intracranial pressure measured with transcranial Doppler); and magnetic resonance imaging (MRI) to assess eye and optic nerve structure and cerebrospinal fluid flow. In-flight measures included visual acuity, amsler grid, IOP, OCT imaging of the posterior eye, fundoscopy, ocular ultrasound, cardiovascular function, and blood flow velocity in the MCA. The primary data analysis is complete.

Currently, we are conducting more detailed analysis of key variables that demonstrate significant spaceflight induced changes. Moreover, we are working to integrate the study results across the physiologic systems studied. Currently, multiple manuscripts are being drafted for publication in peer-reviewed journals. Preliminary results were recently reported by Dr. Macias at the 2018 Human Research Program (HRP) Workshop.

Bibliography Type: Description: (Last Updated: 12/13/2021)  Show Cumulative Bibliography Listing
 
Abstracts for Journals and Proceedings Macias BR. "Spaceflight associated neuro-ocular syndrome during exploration missions." Invited Talk. The Ohio State University, Biomedical Engineering Seminar Series Presentation, Columbus, OH, October 2018.

The Ohio State University, Biomedical Engineering Seminar Series Presentation, Columbus, OH. (Invited), October 2018. , Oct-2018

Abstracts for Journals and Proceedings Laurie S. "Spaceflight associated neuro-ocular syndrome." Invited Talks: The Ohio State University, Ophthalmology Grand Rounds Presentation, Columbus, OH, October 2018.

Invited Talks: The Ohio State University, Ophthalmology Grand Rounds Presentation, Columbus, OH, October 2018. , Oct-2018

Abstracts for Journals and Proceedings Macias BR, Balasubramanian S, Huang A, Liu JHK, Lee SMC, Laurie S, Feiveson A, Stenger MB. "Fluid Shift Induced Alterations of the Optic Nerve Head and Peripapillary Choroid Assessed using Optical Coherence Tomography." Association for Research in Vision and Ophthalmology Meeting, Baltimore, Maryland, April 2017.

Association for Research in Vision and Ophthalmology Meeting, Baltimore, Maryland, April 2017. , Apr-2017

Abstracts for Journals and Proceedings Sass A, Rohr J, Stenger M, Macias B, Sargsyan A, Martin B. "Automated method to quantify 3D geometric alterations of the optic nerve and sheath in astronauts." 33rd Annual Meeting of the American Society for Gravitational and Space Research, Seattle, WA, October 25-28, 2017.

33rd Annual Meeting of the American Society for Gravitational and Space Research, Seattle, WA, October 25-28, 2017. , Oct-2017

Abstracts for Journals and Proceedings Rohr J, Sass A, Sater S, Aldrink B, Stenger M, Macias B, Ethier C, Sargsyan A, Martin B. "Inter-operator Reliability Assessment of Optic Nerve Tortuosity in Long-duration Flight Astronauts." 33rd Annual Meeting of the American Society for Gravitational and Space Research, Seattle, WA, October 25-28, 2017.

33rd Annual Meeting of the American Society for Gravitational and Space Research, Seattle, WA, October 25-28, 2017. , Oct-2017

Abstracts for Journals and Proceedings Macias BR, Otto C, Ploutz-Snyder R, Sargsyan A, Alexander D, Kramer L, Riascos R, Samuels B, Gibson C, Patel N, Lee S, Laurie S, Stenger M. "Prospective Observational Study of Ocular Health in ISS Crews – The Ocular Health Study." 2018 NASA Human Research Program Investigators’ Workshop, Galveston, TX, January 22-25, 2018.

2018 NASA Human Research Program Investigators’ Workshop, Galveston, TX, January 22-25, 2018. , Jan-2018

Project Title:  Prospective Observational Study of Ocular Health in ISS Crews (PI=Macias) Reduce
Fiscal Year: FY 2017 
Division: Human Research 
Research Discipline/Element:
HRP HHC:Human Health Countermeasures
Start Date: 01/06/2017  
End Date: 09/30/2019  
Task Last Updated: 01/20/2017 
Download report in PDF pdf
Principal Investigator/Affiliation:   Macias, Brandon  Ph.D. / NASA Johnson Space Center 
Address:  Johnson Space Center Cardiovascular and Vision Laboratory 
2101 NASA Parkway, HAC/B21N-1207 
Houston , TX 77058 
Email: brandon.r.macias@nasa.gov 
Phone: 281-483-2026  
Congressional District: 36 
Web:  
Organization Type: NASA CENTER 
Organization Name: NASA Johnson Space Center 
Joint Agency:  
Comments: NOTE: Became civil servant fall 2020; previously KBR/NASA Johnson Space Center. Prior to that until 2016, was at the University of California, San Diego. 
Co-Investigator(s)
Affiliation: 
Gibson, C. Robert  O.D. Coastal Eye Associates--Texas 
Sargsyan, Ashot  M.D. KBRwyle, Houston, TX 
Alexander, David  M.D. NASA Johnson Space Center 
Ploutz-Snyder, Robert  Ph.D. University of Michigan 
Riascos-Castaneda, Roy  M.D. University of Texas Medical Branch 
Patel, Nimish  O.D., Ph.D. University of Houston 
Samuels, Brian  M.D., Ph.D. University of Alabama at Birmingham 
Kramer, Larry  M.D. The University of Texas 
Lee, Stuart  Ph.D. Wyle Integrated Science and Engineering/NASA Johnson Space Center 
Project Information: Grant/Contract No. Directed Research 
Responsible Center: NASA JSC 
Grant Monitor: Allcorn, Aaron  
Center Contact: 281.244.8402 
aaron.j.allcorn@nasa.gov 
Solicitation / Funding Source: Directed Research 
Grant/Contract No.: Directed Research 
Project Type: FLIGHT 
Flight Program: ISS 
TechPort: No 
No. of Post Docs:  
No. of PhD Candidates:  
No. of Master's Candidates:  
No. of Bachelor's Candidates:  
No. of PhD Degrees:  
No. of Master's Degrees:  
No. of Bachelor's Degrees:  
Human Research Program Elements: (1) HHC:Human Health Countermeasures
Human Research Program Risks: (1) SANS:Risk of Spaceflight Associated Neuro-ocular Syndrome (IRP Rev I)
Human Research Program Gaps: (1) SANS01:We do not know the etiological mechanisms and contributing risk factors for ocular structural and functional changes seen in-flight and postflight (IRP Rev I)
Flight Assignment/Project Notes: NOTE: End date changed to 9/30/2019 (original end date was 11/16/2017) per PI (Ed., 10/9/18)

NOTE: End date changed to 9/30/2018 (original end date was 11/16/2017) per A. Allcorn and PI (Ed., 10/11/17)

Task Description: NOTE: Continuation of "Prospective Observational Study of Ocular Health in ISS Crews" with Dr. Christian Otto as Principal Investigator due to Otto's move in January 2017.

The International Space Station (ISS) Ocular Surveillance Protocol aims to systematically gather physiological data to characterize the Risk of Microgravity-Induced Visual Impairment/Intracranial Pressure (VIIP) on crewmembers assigned to a 6 month ISS increment. The data collected will mirror Medical Requirements Integration Documents (MRID) requirements and testing performed during annual medical exams. The frequency of in-flight and postflight testing will be increased to more accurately assess changes that occur in the visual, vascular, and central nervous systems upon exposure to microgravity and induction of fluid shifting. Monitoring in-flight changes, in addition to postflight recovery, is the main focus of this protocol. A data sharing plan with Medical Operations will reduce redundancy of data acquisition. Preflight, in-flight, and postflight measures include: tonometry, ocular ultrasound, fundoscopy, and visual acuity; while magnetic resonance imaging (MRI), optical coherence tomography (OCT), and bio-microscopy will be captured preflight and postflight exclusively. Two additional, non-MRID measures, blood pressure and cardiac output, will be collected preflight, in-flight, and postflight to assess vascular compliance. Data collection will begin one year prior to flight, continue in-flight approximately every 30 days, and through to one year postflight. In circumstances where abnormalities may persist beyond one year, postflight data will continue to be collected, but as per the MRID requirements (MedB 1.10) and VIIP clinical practice guidelines.

Expected Outcomes

1. It is expected that some crewmembers will experience meaningful and detectable in-flight changes in at least one or more of the following: visual acuity, intraocular pressure, optic disc edema (papilledema), chorioretinal folds, optic nerve sheath distention, optic nerve tortuosity, optic nerve-to-sheath ratio, globe flattening, and retinal “cotton-wool spots.”

2. It is expected that some crewmembers will experience meaningful pre- to postflight changes in one or more of the following: visual acuity, intraocular pressure, optic disc edema (papilledema), chorioretinal folds, optic nerve sheath distention, optic nerve tortuosity, optic nerve-to-sheath ratio, globe flattening, retinal “cotton-wool spots”, vascular compliance, CSF (cerebral spinal fluid) velocity through the aqueduct of Sylvius, and retinal nerve fiber layer.

3. It is expected that if an in-flight or postflight measure deviates from preflight baseline measures, it may have a prolonged recovery to baseline (preflight values) that is positively associated with severity.

Specific Aims

For all measured variables and using currently available on-orbit methodologies, this study has the following specific aims:

1. Characterize the nature of in-flight visual, vascular, and central nervous system changes during six months exposure to microgravity.

2. Document changes from pre- to postflight.

3. Delineate the interaction between individual susceptibility and severity of symptoms.

4. If changes occur, establish the postflight time course for recovery to baseline.

See also: http://www.nasa.gov/mission_pages/station/research/experiments/204.html

Rationale for HRP Directed Research: This research is directed because it contains highly constrained research and there is insufficient time. This research is highly constrained because it is proposing additional data collections of MRID measures pre-, in-, and postflight. Since the co-investigative team collects the MRID data, they are the best source to collect this data as well. Due to the visibility of this risk, there is pressure to characterize the visual changes associated with spaceflight in order to begin to identify the underlying cause. The results of this study will help define and frame the new Risk of Microgravity-Induced Visual Impairment/Intracranial Pressure.

Research Impact/Earth Benefits: Terrestrial Benefits

1. The VIIP syndrome has similarities to terrestrial medical conditions such as glaucoma, Normal Pressure Hydrocephalus (NPH), Idiopathic Intracranial Hypertension (IIH), and high-altitude related illnesses

2. Advances in the tools, techniques, and countermeasures that NASA develops in its VIIP research will benefit these terrestrial clinical populations

3. Identifying the cause(s) and risk factors for the VIIP syndrome will also inform the cause(s) and risk factors for these terrestrial conditions.

Task Progress & Bibliography Information FY2017 
Task Progress: NOTE: Continuation of "Prospective Observational Study of Ocular Health in ISS Crews" with Dr. Christian Otto as Principal Investigator due to Dr. Otto's move in January 2017. See that project for previous reporting.

Bibliography Type: Description: (Last Updated: 12/13/2021)  Show Cumulative Bibliography Listing
 
 None in FY 2017