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在太空飞行中,眼内压和脉络膜厚度对下体负压的反应不同。

Intraocular pressure and choroidal thickness respond differently to lower body negative pressure during spaceflight.

机构信息

KBR, Houston, Texas.

National Aeronautics and Space Administration, Johnson Space Center, Houston, Texas.

出版信息

J Appl Physiol (1985). 2021 Aug 1;131(2):613-620. doi: 10.1152/japplphysiol.01040.2020. Epub 2021 Jun 24.


DOI:10.1152/japplphysiol.01040.2020
PMID:34166098
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8409923/
Abstract

Spaceflight-associated neuro-ocular syndrome (SANS) develops during long-duration (>1 mo) spaceflight presumably because of chronic exposure to a headward fluid shift that occurs in weightlessness. We aimed to determine whether reversing this headward fluid shift with acute application of lower body negative pressure (LBNP) can influence outcome measures at the eye. Intraocular pressure (IOP) and subfoveal choroidal thickness were therefore evaluated by tonometry and optical coherence tomography (OCT), respectively, in 14 International Space Station crewmembers before flight in the seated, supine, and 15° head-down tilt (HDT) postures and during spaceflight, without and with application of 25 mmHg LBNP. IOP in the preflight seated posture was 14.4 mmHg (95% CI, 13.5-15.2 mmHg), and spaceflight elevated this value by 1.3 mmHg (95% CI, 0.7-1.8 mmHg, < 0.001). Acute exposure to LBNP during spaceflight reduced IOP to 14.2 mmHg (95% CI, 13.4-15.0 mmHg), which was equivalent to that of the seated posture ( > 0.99), indicating that venous fluid redistribution by LBNP can influence ocular outcome variables during spaceflight. Choroidal thickness during spaceflight (374 µm, 95% CI, 325-423 µm) increased by 35 µm (95% CI, 25-45 µm, < 0.001), compared with the preflight seated posture (339 µm, 95% CI, 289-388 µm). Acute use of LBNP during spaceflight did not affect choroidal thickness (381 µm, 95% CI, 331-430 µm, = 0.99). The finding that transmission of reduced venous pressure by LBNP did not decrease choroidal thickness suggests that engorgement of this tissue during spaceflight may reflect changes that are secondary to the chronic cerebral venous congestion associated with spaceflight. Spaceflight induces a chronic headward fluid shift that is believed to underlie ocular changes observed in astronauts. The present study demonstrates, for the first time, that reversing this headward fluid shift via application of lower body negative pressure (LBNP) during spaceflight may alter the ocular venous system, as evidenced by a decrease in intraocular pressure. This finding indicates that LBNP has the potential to be an effective countermeasure against the headward fluid shift during spaceflight, which may then be beneficial in preventing or reversing associated ocular changes.

摘要

航天相关的神经眼综合征(SANS)在长时间(>1 个月)的航天飞行中发展,可能是因为在失重状态下慢性暴露于头部向前的液体转移。我们的目的是确定急性应用下体负压(LBNP)是否可以影响眼部的结果测量值。因此,我们通过眼压计和光学相干断层扫描(OCT)分别评估了 14 名国际空间站机组人员在飞行前的坐姿、仰卧位和 15°头低位(HDT)姿势以及飞行期间,在没有和应用 25mmHg LBNP 时的眼压(IOP)和中心凹下脉络膜厚度。飞行前坐姿时的 IOP 为 14.4mmHg(95%CI,13.5-15.2mmHg),而太空飞行将该值升高了 1.3mmHg(95%CI,0.7-1.8mmHg,<0.001)。急性暴露于 LBNP 在太空飞行中降低了 IOP 至 14.2mmHg(95%CI,13.4-15.0mmHg),这与坐姿相当(>0.99),表明 LBNP 引起的静脉液体再分布可以影响太空飞行期间的眼部结果变量。飞行时脉络膜厚度(374μm,95%CI,325-423μm)增加了 35μm(95%CI,25-45μm,<0.001),与飞行前的坐姿相比(339μm,95%CI,289-388μm)。太空飞行期间急性使用 LBNP 并不影响脉络膜厚度(381μm,95%CI,331-430μm,=0.99)。LBNP 传递的降低静脉压力没有降低脉络膜厚度的发现表明,这种组织的充盈在太空中可能反映了与太空飞行相关的慢性脑静脉充血相关的继发性变化。太空飞行引起了一种慢性的头部向前的液体转移,据信这是宇航员眼部变化的基础。本研究首次证明,通过在太空飞行期间应用下体负压(LBNP)来逆转这种头部向前的液体转移,可能会改变眼部静脉系统,表现为眼压降低。这一发现表明,LBNP 有可能成为太空飞行中头部向前的液体转移的有效对抗措施,从而可能有助于预防或逆转相关的眼部变化。

相似文献

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[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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[8]
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[9]
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[10]
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本文引用的文献

[1]
Mechanical countermeasures to headward fluid shifts.

J Appl Physiol (1985). 2021-6-1

[2]
Association of Long-Duration Spaceflight With Anterior and Posterior Ocular Structure Changes in Astronauts and Their Recovery.

JAMA Ophthalmol. 2020-5-1

[3]
Optic Disc Edema and Choroidal Engorgement in Astronauts During Spaceflight and Individuals Exposed to Bed Rest.

JAMA Ophthalmol. 2020-2-1

[4]
Assessment of Jugular Venous Blood Flow Stasis and Thrombosis During Spaceflight.

JAMA Netw Open. 2019-11-1

[5]
Episcleral Venous Pressure and the Ocular Hypotensive Effects of Topical and Intracameral Prostaglandin Analogs.

J Glaucoma. 2019-9

[6]
Gravitational Influence on Intraocular Pressure: Implications for Spaceflight and Disease.

J Glaucoma. 2019-8

[7]
The Increment of Choroidal Thickness in Euthyroid Graves' Ophthalmopathy: Is It an Early Sign of Venous Congestion?

J Ophthalmol. 2018-8-28

[8]
The Impact of Choroidal Swelling on Optic Nerve Head Deformation.

Invest Ophthalmol Vis Sci. 2018-8-1

[9]
Icare rebound tonometers: review of their characteristics and ease of use.

Clin Ophthalmol. 2018-7-12

[10]
Spaceflight-Induced Intracranial Hypertension and Visual Impairment: Pathophysiology and Countermeasures.

Physiol Rev. 2018-1-1

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