Optic nerve sheath diameter and spaceflight: defining shortcomings and future directions

Abstract

Neuro-ocular changes during long-duration space flight are known as spaceflight-associated neuro-ocular syndrome (SANS). The ability to detect, monitor, and prevent SANS is a priority of current space medicine research efforts. Optic nerve sheath diameter (ONSD) measurement has been used both terrestrially and in microgravity as a proxy for measurements of elevated intracranial pressure. ONSD shows promise as a potential method of identifying and quantitating neuro-ocular changes during space flight. This review examines 13 studies measuring ONSD and its relationship to microgravity exposure or ground-based analogs, including head-down tilt, dry immersion, or animal models. The goal of this correspondence is to describe heterogeneity in the use of ONSD in the current SANS literature and make recommendations to reduce heterogeneity in future studies through standardization of imaging modalities, measurement techniques, and other aspects of study design.

Fig. 1. Example of anatomy and correct measurement of ONSD.

Both MRI (a) and US (b) are represented in the figure. Note the measurement was conducted on a plane where the hypoechoic arachnoid and dural layer are clearly distinguished from the hyperechoic retroorbital face and subarachnoid space. R Retina, LC lamina cribrosa, ON optic nerve, SAS subarachnoid space, D dura.