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Spaceflight associated neuro-ocular syndrome (SANS): an update on potential microgravity-based pathophysiology and mitigation development

Eye volume 37, pages 2409–2415 (2023)Cite this article

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Abstract

Long-duration spaceflight is associated with neurologic and ophthalmic clinical and imaging findings in astronauts termed spaceflight associated neuro-ocular syndrome (SANS). These microgravity-induced findings have been well documented by the National Aeronautics and Space Administration (NASA) and are clearly a potential risk for future human space exploration. The underlying pathogenesis of SANS is not well understood, although multiple hypotheses have emerged. Terrestrial analogues and potential countermeasures have also been studied to further understand and potentially mitigate SANS. In this manuscript, we review the current understanding of SANS, discuss the prevailing hypotheses for pathogenesis, and describe current developments in terrestrial analogues and potential countermeasures for SANS.

摘要 摘要

太空飞行相关神经视觉综合征 (Spaceflight associated neuro-ocular syndrome, SANS) 是指长时间的太空飞行与宇航员的神经和眼科临床和影像的病理性改变。美国国家航空航天局 (National Aeronautics and Space Administration, NASA) 已经详细记录了这些由微重力引起的病理性改变, 这显然是未来人类探索太空的一个潜在风险。尽管出现了多种假设, 但SANS的潜在发病机制仍不清楚。为了进一步了解和缓解SANS, 同时研究了陆地上的类似物与潜在的应对措施。本文回顾了目前对SANS的理解, 讨论了发病机制的假说, 并描述了目前陆地上的类似物与SANS的潜在对策的发展。

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Fig. 1: Pre-flight, in-flight (R-30, 30 days before returning to Earth), and post-flight (R+4, 4 days before returning to Earth) Multicolor Imaging in an astronaut that developed spaceflight associated neuro-ocular syndrome (SANS) during a spaceflight mission.

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Acknowledgements

We thank Tyson Brunstetter, OD, PhD and William Tarver, MD, MPH for their review and input for this manuscript.

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Authors and Affiliations

  1. Michigan Medicine, University of Michigan, Ann Arbor, MI, USA

    Joshua Ong

  2. NASA Ophthalmology Consultant, Moab, UT, USA

    Thomas H. Mader

  3. KBR, NASA Johnson Space Center, Houston, TX, USA

    C. Robert Gibson

  4. South Shore Eye Center, League City, TX, USA

    C. Robert Gibson

  5. Aegis Aerospace, Houston, TX, USA

    Sara S. Mason

  6. Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USA

    Andrew G. Lee

  7. Center for Space Medicine, Baylor College of Medicine, Houston, TX, USA

    Andrew G. Lee

  8. The Houston Methodist Research Institute, Houston Methodist Hospital, Houston, TX, USA

    Andrew G. Lee

  9. Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, NY, USA

    Andrew G. Lee

  10. Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, USA

    Andrew G. Lee

  11. University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Andrew G. Lee

  12. Texas A&M College of Medicine, Bryan, TX, USA

    Andrew G. Lee

  13. Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA

    Andrew G. Lee

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JO drafted the initial manuscript. THM, CRG, SSM, and AGL provided critical edits and feedback for the manuscript. All authors contributed to the final version of the manuscript.

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Ong, J., Mader, T.H., Gibson, C.R. et al. Spaceflight associated neuro-ocular syndrome (SANS): an update on potential microgravity-based pathophysiology and mitigation development. Eye 37, 2409–2415 (2023). https://doi.org/10.1038/s41433-023-02522-y

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