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Optic Disc Edema in an Astronaut After Repeat Long-Duration Space Flight

Mader, Thomas H. MD; Gibson, C. Robert OD; Pass, Anastas F. OD, JD; Lee, Andrew G. MD; Killer, Hanspeter E. MD; Hansen, Hans-Christian MD; Dervay, Joseph P. MD; Barratt, Michael R. MD; Tarver, William J. MD; Sargsyan, Ashot E. MD; Kramer, Larry A. MD; Riascos, Roy MD; Bedi, Deepak G. MD; Pettit, Donald R. PhD

doi: 10.1097/WNO.0b013e31829b41a6
Original Contribution

Background: A number of ophthalmic findings including optic disc edema, globe flattening, and choroidal folds have been observed in several astronauts after long-duration space flights. The authors report the first astronaut with previously documented postflight ophthalmic abnormalities who developed new pathological changes after a repeat long-duration mission.

Methods: A case study of an astronaut with 2 long-duration (6 months) exposures to microgravity. Before and after his first long-duration space flight, he underwent complete eye examination, including fundus photography. Before and after his second flight, 9 years later, he underwent fundus photography, optical coherence tomography, ocular ultrasonography, and brain magnetic resonance imaging, as well as in-flight fundus photography and ultrasound.

Results: After his first long-duration mission, the astronaut was documented to have eye findings limited to unilateral choroidal folds and a single cotton wool spot. During a subsequent 6-month mission, he developed more widespread choroidal folds and new onset of optic disc edema in the same eye.

Conclusion: Microgravity-induced anatomical changes that occurred during the first mission may have set the stage for recurrent or additional changes when the astronaut was subjected to physiological stress of repeat space flight.

Department of Ophthalmology (THM), Alaska Native Medical Center, Anchorage, Alaska; Coastal Eye Associates (CRG), Webster, Texas; University Eye Institute (AFP), University of Houston, Houston, Texas; Department of Ophthalmology (AGL), The Methodist Hospital, Houston, Texas; Department of Ophthalmology (HEK), Kantonsspital Aarau, Aarau, Switzerland; Department of Neurology and Psychiatry (H-CH), University Hospital Hamburg-Eppendorf, Hamburg, Germany; NASA Johnson Space Center (JPD, WJT), Space Medicine, Houston, Texas; NASA Johnson Space Center (MRB, DRP), Houston, Texas; Wyle Science, Technology, and Engineering (AES), Houston, Texas; Department of Diagnostic Imaging and Intervention (LAK), University of Texas Health Science Center, Houston, Texas; University of Texas Medical Branch at Galveston (RR), Galveston, Texas; and University of Texas M.D. Anderson Cancer Center (DGB), Houston, Texas.

Address correspondence to Thomas H. Mader, MD, 6550 Farpoint Drive, Anchorage, Alaska 99507; E-mail: tmader@acsalaska.net

The authors report no conflicts of interest.

© 2013 by North American Neuro-Ophthalmology Society