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.
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Table 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
