Intracranial and Intraocular Pressure During Various Degrees of Head-Down Tilt
BACKGROUND: More than half of astronauts develop ophthalmic changes during long-duration spaceflight consistent with an abnormal intraocular and intracranial pressure (IOP, ICP) difference. The aim of our study was to assess IOP and ICP during head-down tilt (HDT) and the additive
or attenuating effects of 1% CO2 and lower body negative pressure (LBNP).
METHODS: In Experiment I, IOP and ICP were measured in nine healthy subjects after 3.5 h HDT in five conditions: -6°, -12°, and -18° HDT, -12° with 1% CO2, and -12° with -20 mmHg LBNP. In Experiment II, IOP was measured in 16 healthy subjects after 5 min tilt at +12°, 0°, -6°, -12°, -18°, and -24°, with and without -40 mmHg LBNP.
RESULTS: ICP was only found to increase from supine baseline during -18° HDT (9.2 ± 0.9 and 14.4 ± 1 mmHg, respectively), whereas IOP increased from 15.7 ± 0.3 mmHg at 0° to 17.9 ± 0.4 mmHg during -12° HDT and from 15.3 ± 0.4 mmHg at 0° to 18.7 ± 0.4 mmHg during -18° HDT. The addition of -20 mmHg LBNP or 1% CO2 had no further effects on ICP or IOP. However, the use of -40 mmHg LBNP during HDT lowered IOP back to baseline values, except at −24° HDT.
DISCUSSION: A small, posterior intraocular-intracranial pressure difference (IOP > ICP) is maintained during HDT, and a sustained or further decreased difference may lead to structural changes in the eye in real and simulated microgravity.
Marshall-Goebel K, Mulder E, Bershad E, Laing C, Eklund A, Malm J, Stern C, Rittweger J. Intracranial and intraocular pressure during various degrees of head-down tilt. Aerosp Med Hum Perform. 2017; 88(1):10–16.
METHODS: In Experiment I, IOP and ICP were measured in nine healthy subjects after 3.5 h HDT in five conditions: -6°, -12°, and -18° HDT, -12° with 1% CO2, and -12° with -20 mmHg LBNP. In Experiment II, IOP was measured in 16 healthy subjects after 5 min tilt at +12°, 0°, -6°, -12°, -18°, and -24°, with and without -40 mmHg LBNP.
RESULTS: ICP was only found to increase from supine baseline during -18° HDT (9.2 ± 0.9 and 14.4 ± 1 mmHg, respectively), whereas IOP increased from 15.7 ± 0.3 mmHg at 0° to 17.9 ± 0.4 mmHg during -12° HDT and from 15.3 ± 0.4 mmHg at 0° to 18.7 ± 0.4 mmHg during -18° HDT. The addition of -20 mmHg LBNP or 1% CO2 had no further effects on ICP or IOP. However, the use of -40 mmHg LBNP during HDT lowered IOP back to baseline values, except at −24° HDT.
DISCUSSION: A small, posterior intraocular-intracranial pressure difference (IOP > ICP) is maintained during HDT, and a sustained or further decreased difference may lead to structural changes in the eye in real and simulated microgravity.
Marshall-Goebel K, Mulder E, Bershad E, Laing C, Eklund A, Malm J, Stern C, Rittweger J. Intracranial and intraocular pressure during various degrees of head-down tilt. Aerosp Med Hum Perform. 2017; 88(1):10–16.
Keywords: carbon dioxide; lower body negative pressure; posture; translaminar pressure gradient; visual impairment
Document Type: Research Article
Affiliations: Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
Publication date: 01 January 2017
- This journal (formerly Aviation, Space, and Environmental Medicine), representing the members of the Aerospace Medical Association, is published monthly for those interested in aerospace medicine and human performance. It is devoted to serving and supporting all who explore, travel, work, or live in hazardous environments ranging from beneath the sea to the outermost reaches of space. The original scientific articles in this journal provide the latest available information on investigations into such areas as changes in ambient pressure, motion sickness, increased or decreased gravitational forces, thermal stresses, vision, fatigue, circadian rhythms, psychological stress, artificial environments, predictors of success, health maintenance, human factors engineering, clinical care, and others. This journal also publishes notes on scientific news and technical items of interest to the general reader, and provides teaching material and reviews for health care professionals.
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