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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). In this book, the editors 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. The book describes the possible mechanisms and potential etiologies for SANS, and provides an update and review on 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). The ocular imaging findings (e.g., retinal nerve fiber layer, optic disc, and choroidal changes on optical coherence tomography) of SANS is also described, including the intraorbital and intracranial findings on orbital ultrasound and magnetic resonance imaging. The knowledge gaps for in-flight and terrestrial human research including potential countermeasures for future stud is also explored, including reports on the in-flight and terrestrial human and animal research being investigated by NASA and its partners to study SANS both prospectively and longitudinally and in preparation for future long duration manned missions to space including the moon, the asteroid belt, or Mars. We think this is a unique topic and hope that NASA and its research partners continue to study SANS in preparation for future longer duration manned space missions.
List of contents
1. An introduction to space medicine and the physiological effects of spaceflight on the human body
2. Neuro-ocular findings and mechanisms in Spaceflight Associated Neuro-Ocular Syndrome
3. Optical coherence tomography and Spaceflight Associated Neuro-Ocular Syndrome
4. Clinical neuroimaging of Spaceflight Associated Neuro-Ocular Syndrome
5. Genetics, vitamins, and Spaceflight Associated Neuro-Ocular Syndrome
6. Glymphatic system and Spaceflight Associated Neuro-Ocular Syndrome
7. Mechanical alterations of the brain and optic chiasm in Spaceflight Associated Neuro-Ocular Syndrome
8. Intraocular pressure and Spaceflight Associated Neuro-Ocular Syndrome
9. Intraocular and intracranial pressure relationships for Spaceflight Associated Neuro-Ocular Syndrome countermeasures
10. Pathophysiology of cerebral edema and its connection to Spaceflight Associated Neuro-Ocular Syndrome
11. Cerebral hemodynamic changes and invasive/noninvasive monitoring for Spaceflight Associated Neuro-Ocular Syndrome
12. Terrestrial analogs for Spaceflight Associated Neuro-Ocular Syndrome
13. Potential countermeasures for Spaceflight Associated Neuro-Ocular
14. Space-induced neuroocular syndrome in astronautsdthe ICP hypothesis
15. Multimodal assessment of visual function and ocular structure for monitoring Spaceflight Associated Neuro-Ocular Syndrome
About the author
Dr. Lee began his academic career in 1994 as an Instructor in the Department of Ophthalmology, Neurology, and Neurosurgery at Baylor College of Medicine, becoming an Associate Professor in 1998. In 2000, he joined the University of Iowa as an Associate Professor and later became a full Professor. He serves on the editorial boards of 12 journals, including the American Journal of Ophthalmology, and is the Editor in Chief of the Journal of Academic Ophthalmology. A recipient of multiple awards from the American Academy of Ophthalmology, Dr. Lee has a strong interest in resident training and has published extensively on teaching methods in ophthalmology residency programs. In 2009, he joined Houston Methodist Hospital and Research Institute, where he currently serves as Chair of the Blanton Eye Institute and is a Professor at Weill Cornell Medical College.Joshua Ong, MD is a resident physician with a passion for protecting astronaut health. He has conducted research on several space medicine research projects, including a project that launched into space. He has presented at the National Aeronautics and Space Administration (NASA) Human Research Program Investigators' Workshop and strives to continue his lifelong journey in ophthalmology and space medicine.
