Mampre David, Spaide Richard, Mason Sara, Van Baalen Mary, Gibson C Robert, Mader Thomas H, Wostyn Peter, Briggs John, Brown David, Lee Andrew G, Patel Nimesh, Tarver William, Brunstetter Tyson
Aerosp Med Hum Perform. 2025 Jun;96(6):496-508. doi: 10.3357/AMHP.6602.2025.
Novel ocular findings have been identified in spaceflight. We discuss their potential association with Spaceflight Associated Neuro-ocular Syndrome (SANS) and integrate them in a framework that may help explain the pathophysiology.
We reviewed literature using the Medline/PubMed database starting in October 2020. Search terms included ocular circulation, hyperopia, serous chorioretinopathy, pigment epithelial detachment, choroidal folds, choroidal thickening, pachychoroid disease, optic disc edema, venous overload choroidopathy. No date exclusions were placed on the search. Articles were reviewed for relevance. Articles relevant to the pathophysiology of choroidal thickening and choroidal venous overload as it applies to SANS were included.
Terrestrial venous overload choroidopathy is thought to be due to impediment to choroidal venous outflow, resulting in dilation of choroidal veins, increased choroidal thickness, pigment epithelial detachments, and serous detachment of the retina. Serous detachment of the retina, pigment epithelial detachments, choroidal folds, and thickening of the choroid were identified on in-flight optical coherence tomography testing. Postflight findings include these, as well as globe flattening. During spaceflight, there is a cephalad displacement of both blood and cerebrospinal fluid. This may lead to pathological consequences in the eye. Remodeling of the choroidal venous vortex system may result in continuance of pathophysiological findings after return to Earth, suggesting the best strategy is prevention.
Microgravity induced venous overload of the choroid may play a role in SANS pathophysiology, and a venous overload choroidopathy may help explain several SANS features that remain unexplained by an etiology of elevated intracranial pressure. Mampre D, Spaide R, Mason S, Van Baalen M, Gibson CR, Mader TH, Wostyn P, Briggs J, Brown D, Lee AG, Patel N, Tarver W, Brunstetter T. Spaceflight-Associated Neuro-ocular Syndrome as a potential variant of venous overload choriodopathy. Aerosp Med Hum Perform. 2025; 96(6):496-508.
在太空飞行中发现了新的眼部异常表现。我们讨论了它们与太空飞行相关神经眼科综合征（SANS）的潜在关联，并将其整合到一个有助于解释病理生理学的框架中。
我们从2020年10月开始使用Medline/PubMed数据库检索文献。检索词包括眼部循环、远视、浆液性脉络膜视网膜病变、色素上皮脱离、脉络膜皱褶、脉络膜增厚、厚脉络膜疾病、视盘水肿、脉络膜静脉淤血病变。检索未设日期限制。对文章进行相关性审查。纳入与脉络膜增厚和脉络膜静脉淤血的病理生理学相关且适用于SANS的文章。
地面上的脉络膜静脉淤血病变被认为是由于脉络膜静脉流出受阻，导致脉络膜静脉扩张、脉络膜厚度增加、色素上皮脱离以及视网膜浆液性脱离。飞行中的光学相干断层扫描测试发现了视网膜浆液性脱离、色素上皮脱离、脉络膜皱褶和脉络膜增厚。飞行后的表现包括上述这些，以及眼球扁平化。在太空飞行期间，血液和脑脊液都会发生向头侧的移位。这可能会导致眼部出现病理后果。脉络膜静脉涡系统的重塑可能导致返回地球后病理生理学表现持续存在，这表明最佳策略是预防。
微重力引起的脉络膜静脉淤血可能在SANS的病理生理学中起作用，脉络膜静脉淤血病变可能有助于解释一些颅内压升高病因无法解释的SANS特征。曼普雷D、斯帕德R、梅森S、范巴伦M、吉布森CR、马德TH、沃斯汀P、布里格斯J、布朗D、李AG、帕特尔N、塔弗W、布伦斯特特T。太空飞行相关神经眼科综合征作为脉络膜静脉淤血病变的一种潜在变体。航空航天医学与人类表现。2025；96(6):496 - 508。
