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航天飞行相关的神经-眼综合征及地面模拟实验及对策研究进展

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航天飞行相关的神经-眼综合征(spaceflight associated neuro-ocular syndrome,SANS)是指宇航员在长时间航天飞行期间和之后观察到的包括视盘水肿、后极部眼球扁平、脉络膜视网膜皱褶和远视飘移等在内的一系列眼部、神经和神经影像学表现,可能会对飞行员造成短期或长期的视力改变、认知影响或其他有害的健康影响,因此,明确SANS的发病机制,进行有效的地面模拟实验及制定对应的缓解对策对未来更远、更久的航天飞行具有重要的意义.目前SANS的发病机制主要有颅内压升高、脑血容量波动与血管重塑、脑和视交叉向上移位、眼淋巴系统流动失衡、细胞毒性水肿、眼眶脂肪肿胀等.国际上研究较多的地面模拟实验为6°头朝下倾斜卧床休息,能够重现SANS的各种表现,包括视神经鞘扩张、视网膜神经层增厚、脉络膜厚度增加和视盘水肿;此外,干浸浴、抛物线飞行等地面模拟实验也观察到了SANS的部分表现.下体负压作为缓解对策能减轻脉络膜增厚和视神经鞘直径增加,正压力护目镜也有望成为应对SANS的有效对策.该文就国内外相关进展进行综述.
Research progress on spaceflight associated neuro-ocular syndrome,ground simulation experiments and countermeasures
Spaceflight associated neuro-ocular syndrome(SANS)refers to a series of ocular,neurological and neuroimaging manifestations observed in astronauts during and after long-term space flight,including optic disc edema,posterior globe flattening,choroid-retinal folds,and hyperopic refractive shift.These effects may have short-term or long-term on vision,cognition and other aspects of astronauts'health.Therefore,elucidating the pathogenesis of SANS,conducting effective ground simulation experiments,and developing corresponding mitigation strategies are crucial for enabling deeper and longer-duration space exploration.Current understanding of the pathogenesis of SANS includes increased intracranial pressure,fluctions in cerebral blood volume and vascular remodeling,upward displacement of the brain and optic chiasm,imbalance in ocular lymphatic system flow,cytotoxic edema,and orbital fat swelling,etc.Among the various ground simulation experiment,the 6 ° head-down tilt bed rest has been extensively studied and has been shown to replicate various manifestations of SANS,such as optic nerve sheath expansion,retinal nerve layer thickening,choroidal thickness increase and optic disc edema.Additionally,dry immersion and parabolic flight have also demonstrated some aspects of SANS during ground simulation experiments.The use of lower body negative pressure has been identified as a potential countermeasure to reduce choroidal thickening and increase in optic nerve sheath diameter.Furthermore,positive pressure goggles are also expected to be an effective strategy for mitigating the effects of SANS.This article provides a comprehensive review of the relevant advancements in the field of SANS,both domestically and internationally.

spaceflight associated neuro-ocular syndromeground simulation experimentpathogenesismitigation measures

黄锴、董睿、李昕、潘学会、陈小凤

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成都中医药大学眼科学院,成都中医大银海眼科医院,成都 610072

航天飞行相关的神经-眼综合征 发病机制 地面模拟实验 缓解对策

四川省自然科学基金

2023NSFSC1662

2024

眼科学报
中山大学

眼科学报

影响因子:0.274
ISSN:1000-4432
年,卷(期):2024.39(2)