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Area of Science:

  • Space Medicine
  • Ophthalmology
  • Astronaut Health

Background:

  • Predicting optic disc edema (ODE) in astronauts is challenging, impacting resource allocation for monitoring and countermeasures.
  • Identifying crewmembers at low risk for ODE can optimize mission resources and enable alternative activities.

Purpose of the Study:

  • To determine if the magnitude of early in-flight ODE correlates with its magnitude later in a spaceflight mission.
  • To establish if early in-flight OCT measurements can predict later ODE development.

Main Methods:

  • A cohort study of International Space Station (ISS) crewmembers using optical coherence tomography (OCT) for imaging before, during, and after missions.
  • Quantification of preflight and in-flight total retinal thickness (TRT) change (ΔTRT) as an objective measure of ODE.
  • Analysis of ΔTRT at approximately 30 (FD30) and 150 (FD150) flight days using mixed-effects models.

Main Results:

  • A strong association was found between FD30 ΔTRT and FD150 ΔTRT (correlation coefficient = 0.89, P < .001) in 43 ISS crewmembers.
  • Crewmembers with ΔTRT < 20 μm on FD30 had a 2% probability of ΔTRT ≥ 55 μm on FD150.
  • An optimal threshold of ΔTRT > 29 μm on FD30 predicted eyes at risk for ΔTRT ≥ 55 μm on FD150.

Conclusions:

  • Astronauts showing no significant ODE by FD30 are unlikely to develop clinically concerning ODE by FD150.
  • OCT imaging during spaceflight is a valuable tool for predicting the magnitude of ODE in longer missions.
  • These findings can inform targeted monitoring and countermeasures for spaceflight-associated visual impairment.