Age-related visual signal changes induced by hypoxemic hypoxia: a study on aircraft pilots of different ages

Exposure to high altitude leads to a series of alterations of higher nervous functions because of hypobaric hypoxia. Sensory systems, mainly the visual one, seem to be particularly involved. This study aimed to assess the effects of hypoxemic hypoxia on the transmission of the visual stimulus simulating a condition of breathing at an altitude of 18,000 feet (5,486 m) through the administration of an air mixture with 10% O2.

The subjects involved in the study were 98 pilots of military aircraft (male, acclimated, healthy, 20/20 Uncorrected Visual Acuity (UCVA)/Best Corrected Visual Acuity (BCVA), and aged between 26 and 49 years) divided into 2 groups according to age (A: 26-36 years; B: 37-49 years). The visual evoked potentials were initially recorded at sea level (760 mm Hg) and subsequently at a simulated altitude of 18,000 feet (5,486 m) through the administration of an air mixture with 10% O2 that induced a blood saturation of 80% O2 after 15 minutes. The analysis was carried out using two different kinds of stimulus (15' and 60' of arc). The latency and the amplitude of N-75 (N1) and P-100 (P1) waves have been evaluated. Results obtained from visual evoked potentials were analyzed with Student t-test.

In the first group (pilots aged 26-36 years), an increase in both latency and amplitude of P-100 wave was observed and in the second group (pilots aged 37-49 years), an increase was found in latency and a significant reduction in amplitude.

The study suggests the existence of a mechanism or a particular anatomic and physiologic condition (probably the neurovascular coupling) that connects the local neuronal activity and the resulting changes in cerebral perfusion. This complex series of events binds together different structures and cell types, and it seems that younger people have a better resistance against the hypoxic insult to the central nervous system because of more efficient compensatory mechanisms.