Original Investigation

Predicting Spaceflight-Associated Neuro-Ocular Syndrome in International Space Station Astronauts

JAMA Ophthalmology 10.1001/jamaophthalmol.2025.3406

October 09, 2025 at 11:00 AM EDT

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What metrics reliably predict the diagnosis of spaceflight-associated neuro-ocular syndrome (SANS) and its optic disc edema (ODE) severity?In this cohort study, for individual astronauts, a SANS diagnosis or nondiagnosis from prior long-duration spaceflight (LDSF) predicted SANS diagnosis during subsequent LDSF. For individual eyes, an objective measure of ODE (ie, change in peripapillary total retinal thickness within 250 µm of the Bruch membrane opening [ΔTRT]) from prior LDSF was highly predictive of ΔTRT during subsequent LDSF.To our knowledge, these results represent the first known predictors of SANS diagnosis and ODE severity in astronauts engaging in repeat LDSF.

Corresponding Author: Tyson J. Brunstetter, OD, PhD, Space Medicine Operations Division, NASA Johnson Space Center, 2101 NASA Pkwy, Houston, TX 77058 (tyson.j.brunstetter@nasa.gov).

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