Eight cases identified, represent 23.5% of the 34 crewmembers flown
on the ISS, with inflight visual changes and pre-to-postflight
refractive changes. In some cases, the changes were transient while
in others they are persistent with varying degrees of visual
impairment. (1) Decreased intraocular pressure (IOP) postflight was
observed in 3 cases. (2) Fundoscopic exams revealed postflight
findings of choroidal folds in 4 cases, optic disc edema in 5 cases
and presence of cotton wool spots in 3 cases. (3) Optical coherence
tomography (OCT) confirmed findings of choroidal folds and disc
edema and documented retinal nerve fiber layer thickening (4
cases). (4) Findings from MRI examinations showed posterior globe
flattening (5 cases) and optic nerve sheath distension (6 cases).
(5) Opening cerebrospinal fluid (CSF) pressure was elevated in 4
cases postflight reflecting raised intracranial pressure. While the
etiology remains unknown, hypotheses speculate that venous
insufficiency or hypertension in the brain caused by cephalad fluid
shifts during spaceflight are possible mechanisms for ocular
changes in astronauts.
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