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At least 19 records

Visual Impairment/Increased Intracranial Pressure (VIIP): Layman's Summary

To date NASA has documented that seven long duration astronauts have experienced in-flight and post-flight changes in vision and eye anatomy including degraded distant vision, swelling of the back of the eye, and changes in the shape of the globe. We have also documented in a few of these astronauts post-flight, increases in the pressure of the fluid that surrounds the brain and spinal cord. This is referred to as increased intracranial pressure (ICP). The functional and anatomical changes have varied in severity and duration. In the post-flight time period, some individuals have experienced a return to a pre-flight level of visual function while others have experienced changes that remain significantly altered compared to pre-flight. In addition, the increased ICP also persists in the post-flight time period. Currently, the underlying cause or causes of these changes is/are unknown but the spaceflight community at NASA suspects that the shift of blood toward the head and the changes in physiology that accompany it, such as increased intracranial pressure, play a significant role.

Fogarty, Jennifer↗

The Impact of Ocular Pressures, Material Properties and Geometry on Optic Nerve Head Deformation

Alteration in intracranial pressure (ICP) has been associated with various diseases that cause visual impairment, including glaucoma, idiopathic intracranial hypertension and Visual Impairment and Intracranial Pressure (VIIP) syndrome. However, how changes in ICP lead to vision loss is unclear, although it is hypothesized to involve deformations of the tissues in the optic nerve head (ONH). Recently, understanding the effect of ICP alterations on ocular tissues has become a major concern for NASA, where 42 of astronauts that partake in long duration space missions suffer from VIIP syndrome. Astronauts with VIIP syndrome suffer from visual impairment and changes in ocular anatomy that persist after returning to earth (1). It is hypothesized that the cephalad fluid shift that occurs upon entering microgravity increases ICP, which leads to an altered biomechanical environment in the posterior globe and optic nerve sheath, and subsequently VIIP syndrome. Our goal was to develop a finite element (FE) model to simulate the acute effects of elevated ICP on the posterior eye. Here, we simulated how inter-individual differences affect the deformation of ONH tissues. Further, we examined how several different geometries influenced deformations when exposed to elevated ICP.

mathematical models↗

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.↗

Numerical Modeling of Ocular Dysfunction in Space

Upon introduction to microgravity, the near-loss of hydrostatic pressure causes a marked cephalic (headward) shift of fluid in an astronaut's body. The fluid shift, along with other factors of spaceflight, induces a cascade of interdependent physiological responses which occur at varying time scales. Long-duration missions carry an increased risk for the development of the Visual Impairment and Intracranial Pressure (VIIP) syndrome, a spectrum of ophthalmic changes including posterior globe flattening, choroidal folds, distension of the optic nerve sheath, kinking of the optic nerve and potentially permanent degradation of visual function. In the cases of VIIP found to date, the initial onset of symptoms occurred after several weeks to several months of spaceflight, by which time the gross bodily fluid distribution is well established. We are developing a suite of numerical models to simulate the effects of fluid shift on the cardiovascular, central nervous and ocular systems. These models calculate the modified mean volumes, flow rates and pressures that are characteristic of the altered quasi-homeostatic state in microgravity, including intracranial and intraocular pressures. The results of the lumped models provide initial and boundary data to a 3D finite element biomechanics simulation of the globe, optic nerve head and retrobulbar subarachnoid space. The integrated set of models will be used to investigate the evolution of the biomechanical stress state in the ocular tissues due to long-term exposure to microgravity.

intraocular pressure↗

A Framework for Modelling Connective Tissue Changes in VIIP Syndrome

Insertion of astronauts into microgravity induces a cascade of physiological adaptations, notably including a cephalad fluid shift. Longer-duration flights carry an increased risk of developing Visual Impairment and Intracranial Pressure (VIIP) syndrome, a spectrum of ophthalmic changes including posterior globe flattening, choroidal folds, distension of the optic nerve sheath, kinking of the optic nerve and potentially permanent degradation of visual function. The slow onset of changes in VIIP, their chronic nature, and the similarity of certain clinical features of VIIP to ophthalmic findings in patients with raised intracranial pressure strongly suggest that: (i) biomechanical factors play a role in VIIP, and (ii) connective tissue remodeling must be accounted for if we wish to understand the pathology of VIIP. Our goal is to elucidate the pathophysiology of VIIP and suggest countermeasures based on biomechanical modeling of ocular tissues, suitably informed by experimental data, and followed by validation and verification. We specifically seek to understand the quasi-homeostatic state that evolves over weeks to months in space, during which ocular tissue remodeling occurs. This effort is informed by three bodies of work: (i) modeling of cephalad fluid shifts; (ii) modeling of ophthalmic tissue biomechanics in glaucoma; and (iii) modeling of connective tissue changes in response to biomechanical loading.

microgravity↗

Numerical Modeling of Ophthalmic Response to Space

To investigate ophthalmic changes in spaceflight, we would like to predict the impact of blood dysregulation and elevated intracranial pressure (ICP) on Intraocular Pressure (IOP). Unlike other physiological systems, there are very few lumped parameter models of the eye. The eye model described here is novel in its inclusion of the human choroid and retrobulbar subarachnoid space (rSAS), which are key elements in investigating the impact of increased ICP and ocular blood volume. Some ingenuity was required in modeling the blood and rSAS compartments due to the lack of quantitative data on essential hydrodynamic quantities, such as net choroidal volume and blood flowrate, inlet and exit pressures, and material properties, such as compliances between compartments.

intracranial pressure↗

Finite Element Modeling Techniques for Analysis of VIIP

Visual Impairment and Intracranial Pressure (VIIP) syndrome is a major health concern for long-duration space missions. Currently, it is thought that a cephalad fluid shift in microgravity causes elevated intracranial pressure (ICP) that is transmitted along the optic nerve sheath (ONS). We hypothesize that this in turn leads to alteration and remodeling of connective tissue in the posterior eye which impacts vision. Finite element (FE) analysis is a powerful tool for examining the effects of mechanical loads in complex geometries. Our goal is to build a FE analysis framework to understand the response of the lamina cribrosa and optic nerve head to elevations in ICP in VIIP.

eye (anatomy)↗

Optic Nerve Sheath Mechanics in VIIP Syndrome

Visual Impairment and Intracranial Pressure (VIIP) syndrome results in a loss of visual function and occurs in astronauts following long-duration spaceflight. Understanding the mechanisms that lead to the ocular changes involved in VIIP is of critical importance for space medicine research. Although the exact mechanisms of VIIP are not yet known, it is hypothesized that microgravity-induced increases in intracranial pressures (ICP) drive the remodeling of the optic nerve sheath, leading to compression of the optic nerve which in turn may reduce visual acuity. Some astronauts present with a kink in the optic nerve after return to earth, suggesting that tissue remodeling in response to ICP increases may be taking place. The goal of this work is to characterize the mechanical properties of the optic nerve sheath (dura mater) to better understand its biomechanical response to increased ICP.

microgravity↗

Finite Element Modeling of the Posterior Eye in Microgravity

Microgravity experienced during spaceflight affects astronauts in various ways, including weakened muscles and loss of bone density. Recently, visual impairment and intracranial pressure (VIIP) syndrome has become a major concern for space missions lasting longer than 30 days. Astronauts suffering from VIIP syndrome have changes in ocular anatomical and visual impairment that persist after returning to earth. It is hypothesized that a cephalad fluid shift in microgravity may increase the intracranial pressure (ICP), which leads to an altered biomechanical environment of the posterior globe and optic nerve sheath (ONS).Currently, there is a lack of knowledge of how elevated ICP may lead to vision impairment and connective tissue changes in VIIP. Our goal was to develop a finite element model to simulate the acute effects of elevated ICP on the posterior eye and optic nerve sheath. We used a finite element (FE) analysis approach to understand the response of the lamina cribrosa and optic nerve to the elevations in ICP thought to occur in microgravity and to identify which tissue components have the greatest impact on strain experienced by optic nerve head tissues.

intraocular pressure↗

Characterization of the Biomechanical Behavior of the Optic Nerve Sheath

A major priority in current space medicine research is to characterize the mechanisms in Visual Impairment and Intracranial Pressure (VIIP) syndrome, a group of ophthalmic changes that occur in some astronauts following long-duration spaceflight [1]. It is hypothesized that microgravity-induced cephalad fluid shifts lead to increases in intracranial pressure (ICP), which drives maladaptive remodeling of the optic nerve sheath (ONS). In this study, we investigated the effects of mechanical loading on the porcine ONS to better understand the mechanical response of the ONS to increased ICP.

fluid shift (biological)↗

Visual perception of accelerated nitrogen nuclei interacting with the human retina.

Visual phenomena have now been observed in high-energy nitrogen beams produced at the Berkeley Bevatron. Using a nitrogen beam deflected at about 266 MeV/nucleon, three scientifically trained subjects made a series of observations. These observations confirm earlier hypotheses and argue for electronic excitation in or near the outer segments as the important mechanism. A picture showing a simplified anatomy of the left eye in horizontal section is presented. Three regions where various beam positions intercepted visual nervous structures are indicated.

Budinger, T. F.↗

Contribution to the theory of photopic vision: Retinal phenomena

Principles of thermodynamics are applied to the study of the ultramicroscopic anatomy of the inner eye. Concepts introduced and discussed include: the retina as a three-dimensional sensor, light signals as coherent beams in relation to the dimensions of retinal pigments, pigment effects topographed by the conjugated antennas effect, visualizing lights, the autotropic function of hemoglobin and some cytochromes, and reversible structural arrangements during photopic adaptation. A paleoecological diagram is presented which traces the evolution of scotopic vision (primitive system) to photopic vision (secondary system) through the emergence of structures sensitive to the intensity, temperature, and wavelengths of the visible range.

Calvet, H.↗

Dissemination of information about the technologies of the Vision Research Lab through the World Wide Web

The Vision Research Lab at NASA John Glenn Research Center is headed by Dr. Rafat Ansari. Dr. Ansari and other researchers have developed technologies that primarily use laser and fiber optics to non-invasively detect different ailments and diseases of the eye. One of my goals as a LERCIP intern and ACCESS scholar for the 2004 summer is to inform other NASA employees, researchers and the general public about these technologies through the development of a website. The website incorporates the theme that the eye is a window to the body. Thus by investigating the processes of the eye, we can better understand and diagnosis different ailments and diseases. These ailments occur in not only earth bound humans, but astronauts as well as a result of exposure to elevated levels of radiation and microgravity conditions. Thus the technologies being developed at the Vision Research Lab are invaluable to humans on Earth in addition to those astronauts in space. One of my first goals was to research the technologies being developed at the lab. The first several days were spent immersing myself in the various articles, journals and reports about the theories behind Dynamic Light Scattering, Laser Doppler Flowmetry, Autofluoresence, Raman Spectroscopy, Polarimetry and Oximetry. Interviews with the other researchers proved invaluable to help understand these theories as well gain hands on experience with the devices being developed using these technologies. The rest of the Vision Research Team and I sat down and discussed how the overall website should be presented. Combining this information with the knowledge of the theories and applications of the hardware being developed, I worked out different ideas to present this information. I quickly learned Paint Shop Pro 8 and FrontPage 2002, as well as using online tutorials and other resources to help design an effective website. The Vision Research Lab website incorporates the anatomy and physiology of the eye, different diseases that affect the eye and the technologies being develop at the lab to help diagnosis these diseases. It also includes background information on Dr. Ansari as well as other researchers involved in the lab and it includes segments on patents, awards and achievements. There are links to help viewers navigate to internal and external websites to further investigate different ideas and hrther understand the implications of these technologies at being developed.

Dorais, Christopher M.↗

The Influence of Gravito-Inertial Force on Sensorimotor Integration and Reflexive Responses

Sensorimotor responses (e.g.. eye movements, spinal reflexes, etc depend upon the interpretation of the neural signals from the sensory systems. Since neural signals from the otoliths may represent either tilt (gravity) or translation (linear inertial force), sensory signals from the otolith organs are necessarily somewhat ambiguous. Therefore. the neural responses to changing otolith signals depend upon the context of the stimulation (e.g- active vs. passive, relative orientation of gravity, etc.) as well as upon other sensory signals (e.g., vision. canals, etc.). This session will focus upon the -role -played by the sensory signals from the otolith organs in producing efficient sensorimotor and behavioral responses. Curthoys will show the influence of the peripheral anatomy and physiology. Tomko will discuss the influence of tilt and translational otolith signals on eye movements. Merfeld will demonstrate the rate otolith organs play during the interaction of sensory signals from the canals and otoliths. Watt will show the influence of the otoliths on spinal/postural responses. Guedry will discuss the contribution of vestibular information to "path of movement"' perception and to the development of a stable vertical reference. Sensorimotor responses to the ambiguous inertial force stimulation provide an important tool to investigate how the nervous system processes patterns of sensory information and yields functional sensorimotor responses.

Curthoys, Ian S.↗