The odyssey of the ocular and cerebrospinal fluids during a mission to Mars: the 'ocular glymphatic system' under pressure

Autor: Peter Wostyn, Thomas H. Mader, Charles Robert Gibson
Rok vydání: 2021
Předmět:
Zdroj: Eye (Lond)
ISSN: 1476-5454
0950-222X
DOI: 10.1038/s41433-021-01721-9
Popis: A significant proportion of the astronauts who spend extended periods in microgravity develop ophthalmic abnormalities including optic disc edema, globe flattening, chorioretinal folds, and hyperopic refractive error shifts. A constellation of these neuro-ophthalmic findings has been termed "spaceflight-associated neuro-ocular syndrome". Understanding this syndrome is currently a top priority for NASA, especially in view of future long-duration missions (e.g., Mars missions). The recent discovery of an "ocular glymphatic system" can potentially help to unlock mechanisms underlying microgravity-induced optic disc edema. Indeed, a major paradigm shift is currently occurring in our understanding of transport of fluids and solutes through the optic nerve following the recent discovery of an optic nerve glymphatic pathway for influx of cerebrospinal fluid. In addition, the recent identification of an entirely new glymphatic pathway for efflux of ocular fluid may have profound implications for fluid dynamics in the eye. Observations pertaining to this ocular glymphatic pathway provide critical new insights into how intracranial pressure can alter basic fluid transport in the eye. We believe that these novel findings have the potential to be game changers in our understanding of the pathogenesis of optic disc edema in astronauts. In the present review, we integrate these new insights with findings on the intracranial and neuro-ophthalmologic effects of microgravity in one coherent conceptual framework. Further studies in this area of investigation could not only provide exciting new insights into the mechanisms underlying microgravity-induced optic disc edema but also offer opportunities to develop countermeasure strategies.摘要: 在长时间处于微重力状态的宇航员中, 大部分人会出现视力异常, 包括视盘水肿、眼球扁平、脉膜视网膜皱褶和远视屈光不正。这些神经眼科的发现被称为“太空飞行相关神经眼综合征”。了解这一综合征目前是美国宇航局的首要任务, 特别是考虑到未来的长期任务 (如火星任务等) 。最近发现的“眼淋巴系统”可能有助于解开微重力引起视盘水肿的潜在机制。事实上, 随着最近发现了视神经-淋巴通道, 我们对液体和溶质通过视神经传输的理解正在发生重大的范式转变。此外, 最近发现了一种全新的眼内液体流出的淋巴途径可能对眼液动力学有深远的影响。针对眼部淋巴通路的观察为颅内压如何改变眼内基本液体运输提供了重要的新见解。我们相信, 这些新发现有可能改变我们对宇航员视盘水肿发病机制的理解。在目前的综述中, 我们将这些新的见解与微重力对颅内和神经眼科影响的研究结果整合在一个续贯的概念框架中。该领域的后续研究不仅可以为微重力诱导视盘水肿的机制提供令人兴奋的新见解, 而且也为制定相应的对策提供了机会。.
Databáze: OpenAIRE
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