Space missions may damage eyes

Astronauts experience bone and muscle loss in the weightlessness of space, and now the first study of returning space travelers’ eyes suggests that prolonged amounts of time in orbit can take a significant toll on vision, although the long-term effects aren’t clear.

The new study, of more than 300 astronauts in the U.S. space program, found that almost 50 percent of those who served on long missions - six months or more - reported experiencing new problems with their ability to see objects near to them while in space and for some time after returning to Earth. Roughly 23 percent of astronauts who spent shorter periods in orbit reported problems with their near vision during their missions and after getting home.

The NASA-funded researchers also did physical exams on seven male astronauts who complained of vision problems after returning from six-month tours in space. They found several signs of eye stress in all of them, including a buildup of fluid around the optic nerve, the development of folds in the bed of vessels that supply blood to the retina, flattening of the eyeball and more.

“People have been flying in space for 50 years and nobody has gone blind yet,” said Dr. Tom Mader, an ophthalmologist at the Alaska Native Medical Center, in Anchorage, who led the study. “But it’s still something to be concerned about,” he told Reuters Health.

Mader said the effects may be due to increased pressure of the fluid surrounding the brain - the result of less gravity than on Earth - that fails to drain well back into the body. But the precise mechanism is unclear.

To describe the history, clinical findings, and possible etiologies of ophthalmic findings discovered in 7 astronauts after long-duration space flight, and document vision changes in approximately 300 additional astronauts.

Retrospective, observational examination of ophthalmic findings in 7 astronauts and analysis of postflight questionnaires regarding in-flight vision changes in approximately 300 additional astronauts.

Seven astronauts with ophthalmic anomalies upon return from long-duration space missions to the International Space Station and 300 additional astronauts who completed postflight questionnaires regarding in-flight vision changes.

Before and after long-duration space flight, all 7 subjects underwent complete eye examinations, including cycloplegic and/or manifest refraction and fundus photography. Six underwent postmission optical coherence tomography (OCT) and magnetic resonance imaging (MRI); 4 had lumbar punctures (LP). Approximately 300 astronauts were queried regarding visual changes during space missions.

Main Outcome Measures
Refractive change, fundus photograph examination, retina OCT, orbital MRI, LP opening pressures, and examination of visual acuity data.

After 6 months of space flight, 7 astronauts had ophthalmic findings, consisting of disc edema in 5, globe flattening in 5, choroidal folds in 5, cotton wool spots (CWS) in 3, nerve fiber layer thickening by OCT in 6, and decreased near vision in 6 astronauts. Five of 7 with near vision complaints had a hyperopic shift ≥+0.50 diopters (D) between pre/postmission spherical equivalent refraction in 1 or both eyes (range, +0.50 to +1.75 D). These 5 showed globe flattening on MRI. Lumbar punctures performed in the 4 with disc edema documented opening pressures of 22, 21, 28, and 28.5 cm H2O performed 60, 19, 12, and 57 days postmission, respectively. The 300 postflight questionnaires documented that approximately 29% and 60% of astronauts on short and long-duration missions, respectively, experienced a degradation in distant and near visual acuity. Some of these vision changes remain unresolved years after flight.

It’s possible that the loss of gravity causes pressure around the optic nerve to spike, which can damage vision, Mader said. It’s also possible, however, that microgravity environments cause vision problems by lowering pressure in the eye, he added.

“It’s very hard for us at this point to define exactly what is causing all of this,” said Mader, whose group reported its findings in the journal Ophthalmology.

At least one of the seven astronauts examined in the study still displayed some of the documented physical eye changes more than five years after returning from space.

Of astronauts who completed post-flight surveys, a smaller number had problems with long-distance vision while in space - 6.6 percent of those on short missions and 12 percent on missions lasting more than six months.

Some 34 percent of the astronauts on long missions and 11 percent of those on short missions also reported “refraction” changes in their corrective lens requirements, although it’s not clear whether or how long those changes lasted after returning to Earth.

NASA is conducting follow-up studies, including research on the International Space Station, to pin down the mechanism, Mader added. Scientists also will be using magnetic resonance imaging and other tests to carefully assess astronauts’ vision and eye anatomy before and after missions.

David Robertson, who runs the Center for Space Physiology and Medicine at Vanderbilt University Medical Center, in Nashville, Tenn., said the extent of the eye changes was somewhat surprising.

However, he added, it’s well-known that astronauts experience swelling in the face in space, as evidenced by in-flight pictures.

“There are more changes in the eyes that I might have expected, but I would imagine that the increased head-ward movement of fluid during travel in space, together with the puffiness of the face and facial tissues likely also affects the eye,” Robertson said.

So far, studies of astronauts have found no permanent adverse effects on human health from long-term space missions, Robertson said.

Any mission to, say, Mars, likely would require at least 2.5 to 3 years, he added. However, no one has spent that long in space continuously.

The record for the most time spent in space in a single mission is held by Valeri Polyakov, who spent 437.7 days in 1994 and 1995 aboard the Russian Mir spacecraft while orbiting the Earth more than 7,000 times.

Source:  Ophthalmology, online August 17, 2011.

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