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Tarver, W.

Publications and source records attributed to Tarver, W..

Integration of Optical Coherence Tomography Scan Patterns to Augment Clinical Data Suite

Vision changes identified in long duration spaceflight astronauts has led Space Medicine at NASA to adopt a more comprehensive clinical monitoring protocol. Optical Coherence Tomography (OCT) was recently implemented at NASA, including on board the International Space Station in 2013. NASA is collaborating with Heidelberg Engineering to increase the fidelity of the current OCT data set by integrating the traditional circumpapillary OCT image with radial and horizontal block images at the optic nerve head. The retinal nerve fiber layer was segmented by two experienced individuals. Intra-rater (N=4 subjects and 70 images) and inter-rater (N=4 subjects and 221 images) agreement was performed. The results of this analysis and the potential benefits will be presented.

Mason, S.↗

Operational Transition from the First-Generation Heidelberg Spectralis Optical Coherence Tomography [OCT("OCT1")] to the Second-Generation Heidelberg Spectralis OCT("OCT2")

The Heidelberg Spectralis "OCT2", which recently became commercially available, is going to be implemented at the Johnson Space Center Flight Medicine Clinic and on board the International Space Station. Due to the increased scan rate of the "OCT2", this upgrade will allow for significant reduction in valuable crew testing time and also allow for additional capabilities, like OCT Angiography and Multi-Color Fundus Imaging. Due to the custom scans used to monitor Space Flight-Associated Neuro-ocular Syndrome (SANS) in our crewmembers, an evaluation to assess the impacts of transitioning from "OCT1" to "OCT2" was performed. An engineering assessment (N=1) was performed to identify any potential impacts of maintaining an "OCT1" on board ISS while implementing an "OCT2" in the JSC Clinic. "OCT2" implementation will lag JSC FMC clinical implementation due to the flight certification/manifestation process. The clinical assessment was performed (n=12) to identify any impacts due to the replacement of the "OCT1" with the "OCT2" to the longitudinal OCT data across a crewmember's mission/lifetime. The qualitative results from the engineering and clinical evaluation will be reported, as well as the quantitative assessment of the clinical variables

Mason, S.↗

Visual Impairment and Intracranial Hypertension: An Emerging Spaceflight Risk

What is the risk? Given that astronauts exposed to microgravity experience a cephalad fluid shift, and that both symptomatic and asymptomatic astronauts have exhibited optic nerve sheath edema on MRI, there is a high probability that all astronauts have some degree of increased intracranial pressure (ICP; intracranial hypertension), and that those susceptible (via eye architecture, anatomy, narrow optic disc) have a high likelihood of developing papilledema (optic disc edema, globe flattening), choroidal folds, and/or hyperopic shifts and that the degree of edema may determine long-term or permanent vision impairment or loss. Back to back panels on this topic have been developed to address this emerging risk. The first panel will focus on the 6 clinical cases with emphasis on ophthalmic findings and imaging techniques used pre-, in-, and post-flight. The second panel will discuss the operational mitigation and medical requirements, the potential role of CO2 on ISS, and the research approach being developed. In total these back to back panels will explore what is known about this risk, what has been done immediately to address it, and how an integrated research model is being developed.

Fogarty, Jennifer A.↗