OBJECTIVES:
The International Space Station (ISS) Ocular Surveillance protocol aims to systematically gather physiological data to characterize the Risk of Microgravity-Induced Visual Impairment and Intracranial Pressure (VIIP) on crewmembers assigned to a six month ISS Increment. The data collected will mirror Medical Requirements Integration Documents (MRID) requirements and testing performed during annual medical exams. The frequency of in-flight and post flight testing will be increased to more accurately assess changes that occur in the visual, vascular, and central nervous systems upon exposure to microgravity and induction of fluid shifting. Monitoring in-flight changes, in addition to post flight recovery, which is the main focus of this protocol.

The overall objectives of this study include the following:

1. Characterize the nature of in-flight visual, vascular, and central nervous system changes during six months of exposure to microgravity.
2. Document changes from pre- to post flight.
3. Document changes post-flight, including the post flight time course for recovery to baseline.

This investigation hypothesizes that some crewmembers will experience meaningful and detectable changes before, during, and after space flight in at least one or more of the following measurements: visual acuity, intraocular pressure, optic disc edema, choroidal folds, optic nerve sheath distention, optic nerve tortuosity, optic nerve to sheath ratio, globe flattening, and retinal “cotton-wool spots.” Moreover, it is expected that crewmembers will have changes before and after in the Cerebrospinal fluid (CSF) velocity through the aqueduct of Sylvius and the retinal nerve fiber layer. It is further anticipated that measures observed during and after space flight will deviate from the baseline measurements, which may prolonged the recovery period to return to the baseline values.

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Crew health and performance is critical to successful human exploration beyond low Earth orbit. The Human Research Program (HRP) investigates and mitigates the highest risks to human health and performance, providing essential countermeasures and technologies for human space exploration. Risks include physiological and performance effects from hazards such as radiation, altered gravity, and hostile environments, as well as unique challenges in medical support, human factors, and behavioral health support. The HRP utilizes an Integrated Research Plan (IRP) to identify the approach and research activities planned to address these risks, which are assigned to specific Elements within the program. The Human Research Roadmap is the web-based tool for communicating the IRP content.

The Human Research Roadmap is located at: https://humanresearchroadmap.nasa.gov/