Spaceflight Associated Neuro-ocular Syndrome (SANS) and its countermeasures.

Joshua Ong, Sarah Aman, Benjamin J Frankfort, Cihan Kadipasaoglu, Alan Hargens, Thomas Mader, Steven Laurie, Mouayad Masalkhi, Peter Wostyn, Andrew G Lee, Jay C Buckey, Ethan Waisberg, C Robert Gibson, Tyson Brunstetter, Scott M Smith, Sara R Zwart, Jessica M Scott, Tuan Nguyen, Brandon R Macias, Mimi Lan

Journal: Progress in retinal and eye research 2025;106():101340

PMID: 39971096

Full Text on Elsevier Science View on PubMed

Abstract

Astronauts can develop a distinct collection of neuro-ophthalmic findings during long duration spaceflight, collectively known as Spaceflight Associated Neuro-ocular Syndrome (SANS). These clinical characteristics include optic disc edema, hyperopic refractive shifts, globe flattening, and chorioretinal folds, which may pose a health risk for future space exploration. Obtaining knowledge of SANS and countermeasures for its prevention is crucial for upcoming crewed space missions and warrants a multidisciplinary approach. This review examines the potential causes and countermeasures of SANS, including space anticipation glasses, lower body negative pressure, venoconstrictive thigh cuffs, impedance threshold devices, translaminar pressure gradient modulation, centrifugation, artificial gravity, pharmaceuticals, and precision nutritional supplementation. This paper highlights future research directions for understanding the genetic, anthropometric, behavioral, and environmental susceptibilities to SANS as well as how to use terrestrial analogs for testing future mitigation strategies.

Address: Weill Cornell/Rockefeller/Sloan-Kettering Tri-Institutional MD-PhD Program, New York City, New York, USA.; Department of Ophthalmology and Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, MI, USA.; NASA Johnson Space Center, Houston, Texas, USA.; KBR, NASA Space Medicine Operations Division, Houston, TX, USA; South Shore Eye Center, League City, TX, USA.; KBR, NASA Space Medicine Operations Division, Houston, TX, USA.; NASA Ophthalmology Consultant, Moab, UT, USA.; Department of Orthopaedic Surgery, University of California, Altman Clinical and Translational Research Institute, La Jolla, CA, San Diego, USA.; Space Medicine Innovations Laboratory, Geisel School of Medicine at Dartmouth, One Medical Center Drive, Lebanon, NH, USA.; Department of Psychiatry, PC Sint-Amandus, Beernem, Belgium.; Department of Neurology, Houston Methodist Hospital, Houston, TX, USA.; Human Health and Performance Directorate, NASA Johnson Space Center, Houston, TX, USA.; University of Texas Medical Branch, Galveston, TX, USA.; Departments of Ophthalmology and Neuroscience, Baylor College of Medicine, Houston, TX, USA.; Wilmer Eye Institute, Johns Hopkins Medicine, Baltimore, MD, USA.; Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, NY, USA.; University of Cambridge, Cambridge, United Kingdom.; University College Dublin School of Medicine, Belfield, Dublin, Ireland.; The Houston Methodist Research Institute, Houston Methodist Hospital, Houston, TX, USA; Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, NY, USA; Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, USA; University of Texas MD Anderson Cancer Center, Houston, TX, USA; Texas A&M College of Medicine, Bryan, TX, USA; Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USA. Electronic address: [email protected].

DOI: 10.1016/j.preteyeres.2025.101340

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MeSH Terms: Humans, Space Flight, Syndrome, Astronauts, Weightlessness, Eye Diseases, Papilledema