Hostname: page-component-cb9f654ff-lqqdg Total loading time: 0 Render date: 2025-08-03T22:36:02.865Z Has data issue: false hasContentIssue false
  • English
  • Français

Anemia and Spaceflight Associated Neuro-Ocular Syndrome (SANS)

Published online by Cambridge University Press:  31 July 2023

Ethan Waisberg Open the ORCID record for Ethan Waisberg [Opens in a new window] ,
Joshua Ong ,
Mouayad Masalkhi  and
Andrew G. Lee
Ethan Waisberg*
Affiliation:
University College Dublin School of Medicine, Belfield, Dublin, Ireland
Joshua Ong
Affiliation:
Michigan Medicine, University of Michigan, Ann Arbor, Michigan USA
Mouayad Masalkhi
Affiliation:
University College Dublin School of Medicine, Belfield, Dublin, Ireland
Andrew G. Lee
Affiliation:
Center for Space Medicine, Baylor College of Medicine, Houston, Texas USA Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, Texas USA Houston Methodist Research Institute, Houston Methodist Hospital, Houston, Texas USA Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, New York USA Department of Ophthalmology, University of Texas Medical Branch, Galveston, Texas USA University of Texas MD Anderson Cancer Center, Houston, Texas USA Texas A&M College of Medicine, Bryan, Texas USA Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa City, Iowa USA
*
Correspondence: Ethan Waisberg University College Dublin School of Medicine Belfield, Dublin 4, Ireland E-mail: ethan.waisberg@ucdconnect.ie
Get access Rights & Permissions [Opens in a new window]

Abstract

Spaceflight associated neuro-ocular syndrome (SANS) is a collection of distinct findings seen in some astronauts following prolonged spaceflight and is characterized by: optic disc edema, globe flattening, and choroidal folds. In this manuscript, we describe the potential mechanisms linking anemia and SANS. Future research aimed at understanding the relationship between these conditions may help to develop countermeasures and mitigation efforts for SANS.

Keywords

anemiaIIHlong-duration spaceflightSANS

Information

Type
Article Commentary
Information
Prehospital and Disaster Medicine , Volume 38 , Issue 5 , October 2023 , pp. 680 - 682
Check for updates
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Trudel, G, Shahin, N, Ramsay, T, Laneuville, O, Louati, H. Hemolysis contributes to anemia during long-duration space flight. Nat Med. 2022;28(1):59–62.CrossRefGoogle ScholarPubMed
Lee, AG, Mader, TH, Gibson, CR, et al. Spaceflight associated neuro-ocular syndrome (SANS) and the neuro-ophthalmologic effects of microgravity: a review and an update. NPJ Microgravity. 2020;6(1):7.CrossRefGoogle ScholarPubMed
Waisberg, E, Ong, J, Masalkhi, M, Lee, AG. Optic neuropathy in spaceflight-associated neuro-ocular syndrome (SANS). Ir J Med Sci. 2023. Epub ahead of print.CrossRefGoogle Scholar
Smith, SM. Red blood cell and iron metabolism during space flight. Nutrition. 2002;18(10):864–866.CrossRefGoogle ScholarPubMed
Santo, NGD, Cirillo, M, Kirsch, KA, et al. Anemia and erythropoietin in space flights. Seminars in Nephrology. 2005;25(6):379–387.CrossRefGoogle ScholarPubMed
Waisberg, E, Ong, J, Zaman, N, Kamran, SA, Lee, AG, Tavakkoli, A. A non-invasive approach to monitor anemia during long-duration spaceflight with retinal fundus images and deep learning. Life Sciences in Space Research. 2022;33:69–71.CrossRefGoogle ScholarPubMed
Trudel, G, Shahin, N, Ramsay, T, Laneuville, O, Louati, H. Hemolysis contributes to anemia during long-duration space flight. Nat Med. 2022;28(1):59–62.CrossRefGoogle ScholarPubMed
Lee, AG, Mader, TH, Gibson, CR, Brunstetter, TJ, Tarver, WJ. Space flight-associated neuro-ocular syndrome (SANS). Eye (Lond). 2018;32(7):1164–1167.CrossRefGoogle ScholarPubMed
Waisberg, E, Ong, J, Lee, AG. Factors associated with optic disc edema development during spaceflight. JAMA Ophthalmol. 2023;141(4):409.CrossRefGoogle ScholarPubMed
Wall, M. Idiopathic intracranial hypertension. Neurol Clin. 2010;28(3):593–617.CrossRefGoogle ScholarPubMed
Wang, MTM, Bhatti, MT, Danesh-Meyer, HV. Idiopathic intracranial hypertension: pathophysiology, diagnosis, and management. J Clin Neurosci. 2022;95:172–179.CrossRefGoogle ScholarPubMed
Spaceflight Associated Neuro-ocular Syndrome. Glenn Research Center - NASA. https://www1.grc.nasa.gov/space/human-research-program/computational-modeling/spaceflight-associated-neuro-ocular-syndrome/. Accessed May 2, 2023.Google Scholar
Sater, SH, Conley Natividad, G, Seiner, AJ, et al. MRI-based quantification of posterior ocular globe flattening during 60 days of strict 6° head-down tilt bed rest with and without daily centrifugation. J Appl Physiol. 2022;133(6):1349–1355.CrossRefGoogle ScholarPubMed
Waisberg, E, Ong, J, Kamran, SA, et al. Further characterizing the physiological process of posterior globe flattening in spaceflight associated neuro-ocular syndrome with generative adversarial networks. J Appl Physiol. 2023;134(1):150–151.CrossRefGoogle ScholarPubMed
Ferguson, CR, Pardon, LP, Laurie, SS, et al. Incidence and progression of chorioretinal folds during long-duration spaceflight. JAMA Ophthalmology. 2023;141(2):168–175.CrossRefGoogle ScholarPubMed
Mollan, SP, Ali, F, Hassan-Smith, G, Botfield, H, Friedman, DI, Sinclair, AJ. Evolving evidence in adult idiopathic intracranial hypertension: pathophysiology and management. J Neurol Neurosurg Psychiatry. 2016;87(9):982–992.CrossRefGoogle ScholarPubMed
Biousse, V, Rucker, JC, Vignal, C, Crassard, I, Katz, BJ, Newman, NJ. Anemia and papilledema. Am J Ophthalmology. 2003;135(4):437–446.CrossRefGoogle ScholarPubMed
Reid, HA, Harris, W. Reversible papilledema in pernicious anemia. BMJ. 1951;1(4696):20–20.CrossRefGoogle Scholar
Mollan, SP, Ball, AK, Sinclair, AJ, et al. Idiopathic intracranial hypertension associated with iron deficiency anemia: a lesson for management. Eur Neurol. 2009;62(2):105–108.CrossRefGoogle ScholarPubMed
Lin, WV, Berry, S, Nakawah, MO, Sadaka, A, Lee, AG. Idiopathic intracranial hypertension and anemia: a matched case–control study. J Neuro-Ophthalmology. 2020;40(2):163–168.CrossRefGoogle ScholarPubMed
Ardissino, M, Moussa, O, Tang, A, Muttoni, E, Ziprin, P, Purkayastha, S. Idiopathic intracranial hypertension in the British population with obesity. Acta Neurochir. 2019;161(2):239–246.CrossRefGoogle ScholarPubMed
Waisberg, E, Yu, CW, Sverdlichenko, I, Micieli, JA. New onset severe anemia and fulminant idiopathic intracranial hypertension. Can J Neurol Sci. 2021;1–3.Google ScholarPubMed
Yu, CW, Waisberg, E, Kwok, JM, Micieli, JA. Anemia and idiopathic intracranial hypertension: a systematic review and meta-analysis. J Neuro-Ophthalmology. 2022;42(1):e78–e86.CrossRefGoogle ScholarPubMed