A series of ophthalmic changes can occur after astronauts enter the microgravity environment. If these changes are not intervened or treated in a timely manner, it will cause long-term or permanent visual impairment to astronauts, which will not only affect the execution of flight missions, but also threaten the personal safety of astronauts. Although the precise mechanism of these ophthalmic changes in astronauts is still unclear, related studies have found that when astronauts enter the microgravity environment, there is intracranial pressure elevation, nervous system changes, biochemical changes, and lymphoid and venous circulation disorders, which may be involved in the occurrence and development of the disease. This paper summarizes these ophthalmic changes over a period of the last 50 years at home and abroad and their possible mechanisms after astronauts enter the microgravity environment. We want to identify the preventive and treatment measures for these ophthalmic changes, and provide relevant theoretical support for the screening and training of astronauts.
张晨晨 李佳 牛灵芝 王远萍 郑雅娟. 微重力环境引起宇航员眼部改变及其机制的研究进展[J]. 中华眼视光学与视觉科学杂志, 2020, 22(1): 72-77.
Chenchen Zhang, Jia Li, Lingzhi Niu, Yuanping Wang, Yajuan Zheng. Research Progress on Ophthalmic Changes in Astronauts Induced by a Microgravity Environment and the Related Mechanism. Chinese Journal of Optometry Ophthalmology and Visual science, 2020, 22(1): 72-77. DOI: 10.3760/cma.j.issn.1674-845X.2020.01.013
Lakin WD, Stevens SA, Penar PL. Modeling intracranial pressures in microgravity: The influence of the blood-brain barrier. Aviat Space Environ Med, 2007, 78(10): 932-936. DOI: 10.3357/asem.2060.2007.
[3]
De la Torre GG. Cognitive neuroscience in space. Life (Basel), 2014, 4(3): 281-294. DOI: 10.3390/life4030281.
[4]
Alexander DJ. GCR, Hamilton DR, Lee SMC, et al. Evidencereport: Risk of spaceflight-induced intracranial hypertension andvision alterations. NASA, Washington, DC, USA, 2012. https://humanresearchroadmap.nasa.gov/evidence/ reports/viip.pdf.
[5]
Mader TH, Gibson CR, Pass AF, et al. Optic disc edema, globe flattening, choroidal folds, and hyperopic shifts observed in astronauts after long-duration space flight. Ophthalmology, 2011, 118(10): 2058-2069. DOI: 10.1016/j.ophtha.2011.06.021.
[6]
Wostyn P, Killer HE, De Deyn PP. Glymphatic stasis at the site of the lamina cribrosa as a potential mechanism underlying open-angle glaucoma. Clin Exp Ophthalmol, 2017, 45(5): 539- 547. DOI: 10.1111/ceo.12915.
[7]
Hayreh SS. Pathogenesis of optic disc edema in raised intracranial pressure. Prog Retin Eye Res, 2016, 50: 108-144. DOI: 10.1016/j.preteyeres.2015.10.001.
[8]
Lee AG, Mader TH, Gibson CR, et al. Space flight-associated neuro-ocular syndrome. JAMA Ophthalmol, 2017, 135(9): 992- 994. DOI: 10.1001/jamaophthalmol.2017.2396.
[9]
Wostyn P, De Winne F, Stern C, et al. Dilated prelaminar paravascular spaces as a possible mechanism for optic disc edema in astronauts. Aerosp Med Hum Perform, 2018, 89(12): 1089-1091. DOI: 10.3357/AMHP.5095.2018.
[10]
Hansen HC, Helmke K. Validation of the optic nerve sheath response to changing cerebrospinal fluid pressure: ultrasound findings during intrathecal infusion tests. J Neurosurg, 1997, 87(1): 34-40. DOI: 10.3171/jns.1997.87.1.0034.
Degnan AJ, Levy LM. Pseudotumor cerebri: Brief review of clinical syndrome and imaging findings. AJNR Am J Neuroradiol, 2011, 32(11): 1986-1993. DOI: 10.3174/ajnr. A2404.
[13]
Nelson ES, Mulugeta L, Myers JG. Microgravity-induced fluid shift and ophthalmic changes. Life (Basel), 2014, 4(4): 621-665. DOI: 10.3390/life4040621.
[14]
Wu J, Lai TF, Leibovitch I, et al. Persistent posterior globe flattening after orbital cavernous haemangioma excision. Clin Exp Ophthalmol, 2005, 33(4): 424-425. DOI: 10.1111/j.1442- 9071.2005.01016.x.
[15]
Farb RI, Vanek I, Scott JN, et al. Idiopathic intracranial hypertension: the prevalence and morphology of sinovenous stenosis. Neurology, 2003, 60(9): 1418-1424. DOI: 10.1212/01. wnl.0000066683.34093.e2.
[16]
Friberg TR. The etiology of choroidal folds. A biomechanical explanation. Graefes Arch Clin Exp Ophthalmol, 1989, 227(5): 459-464. DOI: 10.1007/bf02172899.
[17]
Killer HE, Jaggi GP, Miller NR. Papilledema revisited: is its pathophysiology really understood? Clin Exp Ophthalmol, 2009, 37(5): 444-447. DOI: 10.1111/j.1442-9071.2009.02059.x.
[18]
Gomez ML, Mojana F, Bartsch DU, et al. Imaging of long-term retinal damage after resolved cotton wool spots. Ophthalmology, 2009, 116(12): 2407-2414. DOI: 10.1016/j.ophtha.2009.05.012.
[19]
Lee AG, Tarver WJ, Mader TH, et al. Neuro-Ophthalmology of Space Flight. J Neuroophthalmol, 2016, 36(1): 85-91. DOI: 10.1097/WNO.0000000000000334.
[20]
Draeger J, Schwartz R, Groenhoff S, et al. Self-tonometry under microgravity conditions. Aviat Space Environ Med, 1995, 66(6): 568-570.
[21]
Schwartz R, Draeger J, Groenhoff S, et al. Results of selftonometry during the 1st German-Russian MIR mission 1992. Ophthalmologe, 1993, 90(6): 640-642.
[22]
Draeger J, Schwartz R, Groenhoff S, et al. Self tonometry during the German 1993 Spacelab D2 mission. Ophthalmologe, 1994, 91(5): 697-699.
[23]
Zhang LF, Hargens AR. Spaceflight-induced intracranial hypertension and visual impairment: Pathophysiology and countermeasures. Physiol Rev, 2018, 98(1): 59-87. DOI: 10.1152/physrev.00017.2016.
[24]
Taibbi G, Cromwell RL, Zanello SB, et al. Ocular outcomes evaluation in a 14-day head-down bed rest study. Aviat Space Environ Med, 2014, 85(10): 983-992. DOI: 10.3357/ASEM. 4055.2014.
[25]
Xu X, Li L, Cao R, et al. Intraocular pressure and ocular perfusion pressure in myopes during 21 min head-down rest. Aviat Space Environ Med, 2010, 81(4): 418-422. DOI: 10.3357/ asem.2629.2010.
[26]
Kuz'min MP. Reactions of retinal vessels and intraocular pressure during 120-day human stay in a horizontal position. Kosm Biol Med, 1973, 7(2): 65-69.
[27]
Chakraborty R, Read SA, Collins MJ. Diurnal variations in axial length, choroidal thickness, intraocular pressure, and ocular biometrics. Invest Ophthalmol Vis Sci, 2011, 52(8): 5121-5129.DOI: 10.1167/iovs.11-7364.
[28]
Weinreb RN, Cook J, Friberg TR. Effect of inverted body position on intraocular pressure. Am J Ophthalmol, 1984, 98(6): 784- 787. DOI: 10.1016/0002-9394(84)90698-6.
Li Z, Rivera CA, Burns AR, et al. Hindlimb unloading depresses corneal epithelial wound healing in mice. J Appl Physiol (1985), 2004, 97(2): 641-647. DOI: 10.1152/japplphysiol.00200.2004.
[31]
Bukowiecki A, Hos D, Cursiefen C, et al. Wound-healing studies in cornea and skin: Parallels, differences and opportunities. Int J Mol Sci, 2017, 18(6). Pii: E1257. DOI: 10.3390/ijms18061257.
[32]
Han KY, Tran JA, Chang JH, et al. Potential role of corneal epithelial cell-derived exosomes in corneal wound healing and neovascularization. Sci Rep, 2017, 7: 40548. DOI: 10.1038/ srep40548.
[33]
Wilson SE. Corneal myofibroblast biology and pathobiology: generation, persistence, and transparency. Exp Eye Res, 2012, 99: 78-88. DOI: 10.1016/j.exer.2012.03.018.
[34]
Beheshti A, Ray S, Fogle H, et al. A microRNA signature and TGF-β1 response were identified as the key master regulators for spaceflight response. PLoS One, 2018, 13(7): e0199621. DOI: 10.1371/journal.pone.0199621.
Cheron G, Leroy A, Palmero-Soler E, et al. Gravity influences top-down signals in visual processing. PLoS One, 2014, 9(1): e82371. DOI: 10.1371/journal.pone.0082371.
[40]
Kravitz DJ, Saleem KS, Baker CI, et al. A new neural framework for visuospatial processing. Nat Rev Neurosci, 2011, 12(4): 217- 230. DOI: 10.1038/nrn3008.
[41]
Davis JR, Vanderploeg JM, Santy PA, et al. Space motion sickness during 24 flights of the space shuttle. Aviat Space Environ Med, 1988, 59(12): 1185-1189.
[42]
Manzey D, Lorenz B, Schiewe A, et al. Behavioral aspects of human adaptation to space: Analyses of cognitive and psychomotor performance in space during an 8-day space mission. Clin Investig, 1993, 71(9): 725-731. DOI: 10.1007/ bf00209727.
[43]
Bock O, Weigelt C, Bloomberg JJ. Cognitive demand of human sensorimotor performance during an extended space mission: A dual-task study. Aviat Space Environ Med, 2010, 81(9): 819- 824. DOI: 10.3357/asem.2608.2010.
[44]
Manzey D, Lorenz B, Poljakov V. Mental performance in extreme environments: Results from a performance monitoring study during a 438-day spaceflight. Ergonomics, 1998, 41(4): 537-559. DOI: 10.1080/001401398186991.
[45]
Ranjan A, Behari J, Mallick BN. Cytomorphometric changes in hippocampal CA1 neurons exposed to simulated microgravity using rats as model. Front Neurol, 2014, 5: 77. DOI: 10.3389/ fneur.2014.00077.
[46]
Pani G, Samari N, Quintens R, et al. Morphological and physiological changes in mature in vitro neuronal networks towards exposure to short-, middle- or long-term simulated microgravity. PLoS One, 2013, 8(9): e73857. DOI: 10.1371/journal.pone. 0073857.
[47]
Sun XQ, Xu ZP, Zhang S, et al. Simulated weightlessness aggravates hypergravity-induced impairment of learning and memory and neuronal apoptosis in rats. Behav Brain Res, 2009, 199(2): 197-202. DOI: 10.1016/j.bbr.2008.11.035.
Mekjavic PJ, Eiken O, Mekjavic IB. Visual function after prolonged bed rest. J Gravit Physiol, 2002, 9(1): P31-32.
[51]
Peters BT, Miller CA, Brady RA, et al. Dynamic visual acuity during walking after long-duration spaceflight. Aviat Space Environ Med, 2011, 82(4): 463-466. DOI: 10.3357/asem.2928. 2011.
[52]
Kaeser P, Orgül S, Zawinka C, et al. Influence of change in body position on choroidal blood flow in normal subjects. Br J Ophthalmol, 2005, 89(10): 1302-1305. DOI: 10.1136/bjo.2005. 067884.
[53]
Kramer LA, Sargsyan AE, Hasan KM, et al. Orbital and intracranial effects of microgravity: Findings at 3-T MR imaging. Radiology, 2012, 263(3): 819-827. DOI: 10.1148/radiol. 12111986.
[54]
Zhang LF, Hargens AR. Intraocular/Intracranial pressure mismatch hypothesis for visual impairment syndrome in space. Aviat Space Environ Med, 2014, 85(1): 78-80. DOI: 10.3357/ asem.3789.2014.
[55]
Platts SH, Bairey Merz CN, Barr Y, et al. Effects of sex and gender on adaptation to space: Cardiovascular alterations. J Womens Health (Larchmt), 2014, 23(11): 950-955. DOI: 10.1089/jwh.2014.4912.
[56]
Wostyn P, De Deyn PP. Why space flight-associated neuroocular syndrome may differ from idiopathic intracranial hypertension. JAMA Ophthalmol, 2018, 136(4): 451-452. DOI: 10.1001/jamaophthalmol.2018.0316.
[57]
Lee AG, Mader TH, Gibson CR, et al. Space flight-associated neuro-ocular syndrome. JAMA Ophthalmol, 2017, 135(9): 992- 994. DOI: 10.1001/jamaophthalmol.2017.2396.
Holly JE, Harmon SM. Sensory conflict compared in microgravity, artificial gravity, motion sickness, and vestibular disorders. J Vestib Res, 2012, 22(2): 81-94. DOI: 10.3233/VES-2012-0441.
[60]
Hargens AR, Bhattacharya R, Schneider SM. Space physiology VI: Exercise, artificial gravity, and countermeasure development for prolonged space flight. Eur J Appl Physiol, 2013, 113(9): 2183-2192. DOI: 10.1007/s00421-012-2523-5.