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All sourcesNASA NTRSDOE OSTI
NASA NTRS2009

Translational Vestibulo-Ocular Reflexes During Off-Vertical Axis Rotation

The translational vestibulo-ocular reflex (tVOR) is an otolith-mediated response that stabilizes near vision during linear acceleration at higher frequencies where visually mediated reflexes are not adequate. The modulation of horizontal and vergence eye movements during Off-Vertical Axis Rotation (OVAR) are presumed to reflect the tVOR in response to the continuously varying linear acceleration in the interaural and nasooccipital axes, respectively. The purpose of this study was to examine the effect of frequency and fixation distance on the modulation of slow phase eye velocity (SPV) as further evidence that the tVOR is elicited during OVAR. Eighteen subjects were rotated about their longitudinal axis tilted by 30 deg off-vertical. Rotational velocities varied between 18 and 288 deg/sec corresponding to a frequency range of 0.05 to 0.8 Hz. Fixation distance was altered by asking subjects to imagine stationary targets that were briefly presented at 0.5, 1 and 2 m during some rotation cycles. The target flash was 40 msec in the nose-up position at eye level. Oculomotor responses were recorded in the dark using infrared binocular videography. Sinusoidal curve fits were used to derive amplitude, phase and bias velocity of the eye movements across multiple rotation cycles. Consistent with previous studies, the modulation of both horizontal and vergence SPV increased with stimulus frequency. The effect of fixation distance was negligible at lower frequencies. The modulation of horizontal and vergence SPV was; however, proportional to fixation distance during OVAR at 0.8 Hz. This increasing sensitivity and dependence on fixation distance of horizontal and vergence SPV during OVAR is consistent with tVOR characteristics measured during other types of linear motion. We conclude that the modulation of horizontal and vergence SPV will be diagnostically more useful at higher stimulus frequencies where the tVOR is more robust.

Wood, Scott J.↗
NASA NTRS2002

Smooth Pursuit Saccade Amplitude Modulation During Exposure to Microgravity

Russian investigators have reported changes in pursuit tracking of a vertically moving point stimulus during space flight. Early in microgravity, changes were manifested by decreased eye movement amplitude (undershooting) and the appearance of correction saccades. As the flight progressed, pursuit of the moving point stimulus deteriorated while associated saccadic movements were unchanged. Immediately postflight there was an improved execution of active head movements indicating that the deficiencies in pursuit function noted in microgravity may be of central origin. In contrast, tests of two cosmonauts showed that horizontal and vertical smooth pursuit were unchanged inflight. However, results of corresponding saccadic tasks showed a tendency toward the overshooting of a horizontal target early inflight with high accuracy developing later inflight, accompanied by an increased saccade velocity and a trend toward decreased saccade latency. Based on these equivocal results, we have further investigated the effects of space flight on the smooth pursuit mechanism during and after short duration flight, and postflight on returning MIR crewmembers. Sinusoidal target movement was presented horizontally at frequencies of 0.33 and 1.0 Hz. Subjects were asked to perform two trials for each stimulus combination: (1) moving eyes-only (EO) and (2) moving eyes and head (EH) with the target motion. Peak amplitude was 30 deg for 0.33 Hz trials and 15 deg for the 1.0 Hz trials. The relationship between saccade amplitude and peak velocity were plotted as a main sequence for each phase of flight, and linear regression analysis allowed us to determine the slope of each main sequence plot. The linear slopes were then combined for each flight phase for each individual subject. The main sequence for both EO and EH trials at both the 0.33 and 1.0 Hz frequencies during flight for the short duration flyers showed a reduction in saccade velocity and amplitude when compared to the preflight main sequence . This difference in the regression slopes between flight phase, head/eye condition (EO or EH), and pursuit target frequency was observed across all subjects (statistically significant at the p<0.02, df= 2). It is interesting to note that postflight for the short duration flyers there was an immediate recovery to the preflight main sequence across all trials. There were no significant differences observed between the preflight slopes for either head movement condition (EO vs. EH). When the immediate postflight (R+O) regression slopes were compared with the preflight slopes, there was a tendency (not significant) for both saccade amplitude and peak velocity to increase during the postflight testing. This tendency had vanished by R+ 1. Of particular interest was the redistribution of saccades during the latter stages of the flight and immediately postflight in the EO condition. At the 1.0 Hz frequency the saccades tended to be clustered near the lowest target velocity. It was also interesting to note that gaze performance (eye in skull + head in space) was consistently better during the EH condition; a finding also observed by our Russian colleagues. As the results of the long duration flight become available we expect that they will not only show that postflight effects will be similar to those observed during the short duration flights, but will also last for a greater period of time following flight. It is not clear what mechanism is responsible for the decreased peak saccadic velocity during flight unless the change is related to the control of retinal slip. For example, it is possible that saccades will tend to initially undershoot their targets by a small percentage and these saccades are then followed, if vision is available, by a small augmenting corrective saccade. It has been postulated that the functional significance of this undershooting tendency is to maintain the spatial representation of the target on the same side of the fovea (as opposedo racing across the fovea) and hence in the same cerebral hemisphere that initiated the primary saccade thus minimizing delays caused by an intra-hemispheric transfer of information . One could also speculate that with saccade velocities greater than normal, additional corrective saccades would be required to bring the target back on the fovea. A less plausible explanation of our findings could be fatigue. Yet it seems unlikely that our subjects would show lower velocities on all inflight test days while showing increased saccade velocities immediately following space flight where fatigue is usually the greatest. Finally, the redistribution effect noted late inflight is likely caused by adaptive changes. Overall, corrective saccades appeared to be used in maintaining gaze on target; reducing retinal slip and assisting space travelers in maintaining clear vision throughout the different phases of the space flight.

Reschke, M. F.↗
NASA NTRS2001

Effect of Acute Exposure to Hypergravity (Gx vs. Gz) on Dynamic Cerebral Autoregulation

We examined the effects of 30 min of exposure to either +3G(sub x) or +3G(sub z) centrifugation on cerebrovascular responses to 800 head-up tilt (HUT) in 14 healthy individuals. Both before and after +3G(sub x) or +3G(sub z) centrifugation, eye-level blood pressure (BP(sub eye)), end tidal CO2 (P(sub ET)CO2), mean cerebral flow velocity (CFV) in the middle cerebral artery (trans cranial Doppler ultrasound), cerebral vascular resistance (CVR) and dynamic cerebral autoregulatory gain (GAIN) were measured with subjects in the supine position and during subsequent 800 HUT for 30 min. Mean BP(sub eye) decreased with HUT in both the G(sub x) (n= 7) and G(sub z) (n=7) groups (P less than 0.00l), with the decrease being greater after centrifugation only in the G(sub z) group (P less than 0.05). P(sub ET)CO2 also decreased with HUT in both groups (P less than 0.0l), but the absolute level of decrease was unaffected by centrifugation. CFV decreased during HUT more significantly after than before centrifugation in both groups (P less than 0.02). However, these greater decreases were not associated with greater increases in CVR. In the supine position after compared to before centrifugation, GAIN increased in both groups (P less than 0.05, suggesting an autoregulatory deficit), with the change being correlated to a measure of otolith function (the linear vestibulo-ocular reflex) in the G(sub x) group (R=0.76, P less than 0.05) but not in the G(sub z) group (R=0.24, P=0.60). However, GAIN was subsequently restored to pre-centrifugation levels during post-centrifugation HUT (i.e., as BP(sub eye) decreased), suggesting that both types of centrifugation resulted in a leftward shift of the cerebral autoregulation curve. We speculate that this leftward shift may have been due to vestibular activation (especially during +G(sub x)) or potentially to an adaptation to reduced cerebral perfusion pressure during +G(sub z).

Serrador, Jorge M.↗
NASA NTRS2011

Postural Stability When Leaning from Perceived Upright

The transition between quiet stance and gait requires the volitional movement of one?s center of mass (COM) toward a limit of stability (LOS). The goal of this study was to measure the effect of leaning from perceived upright on postural stability when voluntarily maintaining fixed stance positions and during perturbations of the support surface. The COM was derived from force plate data in 12 healthy subjects while standing with feet positioned so that lateral base of support was equal to foot length. For all conditions, arms were folded and subjects were instructed to lean without bending at the hips or lifting their feet. The LOS was determined during maximal voluntary leans with eyes open and closed. The COM was then displayed on a monitor located in front of the subject. Subjects were visually guided to lean toward a target position, maintain this position for 10s, return to upright, and then repeat the same targeted lean maneuver with eyes closed. Targets were randomly presented at 2? in 8 directions and between 2-6? in these same directions according to the asymmetric LOS. Subjects were then verbally guided to lean between 2? back and 4? forward prior to a perturbation of the support surface in either a forward or backward direction. The average LOS was 5.8? forward, 2.9? back, and 4.8? in left/right directions, with no significant difference between eyes open and closed. Center of pressure (COP) velocity increased as subjects maintained fixed stance positions farther from upright, with increased variability during eyes closed conditions. The time to stability and COP path length increased as subjects leaned opposite to the direction of the support surface perturbations. We conclude that postural stability is compromised as subjects lean away from perceived upright, except for perturbations that induce sway in the direction opposite the lean. The asymmetric LOS relative to perceived upright favors postural stability for COM movements in the forward direction.

Vanya, Robert D.↗
NASA NTRS2012

Quantifying Pilot Visual Attention in Low Visibility Terminal Operations

Quantifying pilot visual behavior allows researchers to determine not only where a pilot is looking and when, but holds implications for specific behavioral tracking when these data are coupled with flight technical performance. Remote eye tracking systems have been integrated into simulators at NASA Langley with effectively no impact on the pilot environment. This paper discusses the installation and use of a remote eye tracking system. The data collection techniques from a complex human-in-the-loop (HITL) research experiment are discussed; especially, the data reduction algorithms and logic to transform raw eye tracking data into quantified visual behavior metrics, and analysis methods to interpret visual behavior. The findings suggest superior performance for Head-Up Display (HUD) and improved attentional behavior for Head-Down Display (HDD) implementations of Synthetic Vision System (SVS) technologies for low visibility terminal area operations. Keywords: eye tracking, flight deck, NextGen, human machine interface, aviation

Ellis, Kyle K.↗
NASA NTRS2014

Straight Ahead in Microgravity

This joint ESA-NASA study will address adaptive changes in spatial orientation related to the subjective straight ahead, and the use of a vibrotactile sensory aid to reduce perceptual errors. The study will be conducted before and after long-duration expeditions to the International Space Station (ISS) to examine how spatial processing of target location is altered following exposure to microgravity. This project specifically addresses the sensorimotor research gap "What are the changes in sensorimotor function over the course of a mission?" Six ISS crewmembers will be requested to participate in three preflight sessions (between 120 and 60 days prior to launch) and then three postflight sessions on R+0/1 day, R+4 +/-2 days, and R+8 +/-2 days. The three specific aims include: (a) fixation of actual and imagined target locations at different distances; (b) directed eye and arm movements along different spatial reference frames; and (c) the vestibulo-ocular reflex during translation motion with fixation targets at different distances. These measures will be compared between upright and tilted conditions. Measures will then be compared with and without a vibrotactile sensory aid that indicates how far one has tilted relative to the straight-ahead direction. The flight study was been approved by the medical review boards and will be implemented in the upcoming Informed Crew Briefings to solicit flight subject participation. Preliminary data has been recorded on 6 subjects during parabolic flight to examine the spatial coding of eye movements during roll tilt relative to perceived orientations while free-floating during the microgravity phase of parabolic flight or during head tilt in normal gravity. Binocular videographic recordings obtained in darkness allowed us to quantify the mean deviations in gaze trajectories along both horizontal and vertical coordinates relative to the aircraft and head orientations. During some parabolas, a vibrotactile sensory aid provided feedback of body orientation relative to the plane coordinates. RESULTS Both variability and curvature of gaze trajectories increased during roll tilt compared to the upright position. The saccades were less accurate during parabolic flight compared to measurements obtained in normal gravity. Although subjects were instructed to look off in the distance while performing the eye movements, fixation distance varied with vertical gaze direction independent of whether the saccades were made along perceived aircraft or head orientations. The increased errors in gaze trajectories along both perceived orientations during microgravity can be attributed to the otolith's role in spatial coding of eye movements. A change in an individual's egocentric reference might have negative consequences on evaluating the direction of an approaching object or on the accuracy of reaching movements or locomotion. Consequently, investigating how microgravity affects the target location will have theoretical, operational and even clinical implications for future space exploration missions. The use of vibrotactile feedback as a sensorimotor countermeasure is applicable to balance therapy applications for vestibular loss patients and the elderly to mitigate risks due to loss of orientation.

Wood, S. J.↗
NASA NTRS2015

Ocular Outcomes Comparison Between 14- and 70-day Head-down Tilt Bed Rest

INTRODUCTION: Ophthalmological changes, including optic disc edema with optic nerve sheath distension, posterior globe flattening with hyperopic shift, choroidal folds and cotton wool spots have been detected in some astronauts involved in long-duration spaceflights. (sup 1) It is hypothesized that elevated intracranial pressure resulting from microgravity-induced cephalad fluid shifts may be responsible for most of these findings. Head-down tilt bed rest (HTDBR) is a ground-based microgravity analog which also produces cephalad fluid shifts. It is conceivable that prolonged HDTBR exposure may induce ocular changes similar to those experienced in microgravity. Therefore, the purpose of the present study was to compare structural and functional ocular outcomes between 14- and 70-day HDTBR in healthy human subjects. It is hypothesized that 70-d HDTBR induced ocular changes of greater magnitude as compared to 14-d HDTBR. METHODS: Two HDTBR studies were conducted at the NASA Flight Analogs Research Unit, located at The University of Texas Medical Branch at Galveston, TX. Identical NASA standard screening procedures and BR conditions (e.g., strict sleep-wake cycle, standardized diet, continuous video monitoring) were implemented in both studies. Participants spent 14 and/or 70 consecutive days in a 6deg HDT position and did not engage in exercise. Subjects received weekly ocular examinations before, during, and after HDTBR. Ocular testing included: distance and near best-corrected visual acuity (BCVA), cycloplegic refraction, intraocular pressure (IOP) measurement, color vision, red dot test, modified Amsler grid test, confrontational visual field, color fundus photography and Spectral-domain OCT scans of the macula and the optic disc. Pre/post HDTBR differences between the two studies will be evaluated for BCVA, spherical equivalent, IOP, retinal nerve fiber layer (RNFL) thickness and macular OCT parameters. RESULTS: 16 (12 males and 4 females) and 6 (5 males and 1 female) subjects participated in the 14 and 70-day HDTBR studies, respectively. One subject participated in both studies. The demographic and ophthalmological characteristics of the 14-day HDTBR study have been presented elsewhere.2 In the 70- day study, subjects age averaged 39.5 +/- 7.8 years; pre- and post-HDTBR Goldmann IOP were, on average, 15.4 and 14.6 mmHg in the right eye, and 15.3 and 14.4 mmHg in the left eye, respectively; preand post-HDTBR Spectralis OCT (Heidelberg Engineering, GmbH, Heidelberg, Germany) average RNFL thickness were 103.8 and 106 μm in the right eye, and 103 and 104.3 μm in the left eye, respectively. In both studies, color vision, red dot test, modified Amsler grid test and confrontational visual field were within normal limits at all time points; no changes were detected on stereoscopic color optic disc photography. For the above outcomes, preliminary results of the pre/post HDTBR differences between the two studies will be presented at the 2015 Human Research Program Investigators' Workshop. CONCLUSIONS: Although 14-day HDTBR did not seem to induce clinically relevant ocular changes, (sup 2) a systematic evaluation and comparison with the 70-day HDTBR study results will elucidate whether the magnitude of ocular structural and functional changes is affected by the time spent in the recumbent position. Further research will also address the effects of integrated resistance and aerobic training during HDTBR on the ocular outcomes. REFERENCES: 1. Mader TH et al. Optic disc edema, globe flattening, choroidal folds, and hyperopic shifts observed in astronauts after long-duration space flight. Ophthalmology. 2011;118(10):2058-69. 2. Taibbi G et al. Ocular outcomes evaluation in a 14-day head-down bed rest study. Aviat Space Environ Med. 2014;85(10):983-92.

Cromwell, R.L.↗
NASA NTRS2016

Microgravity-Driven Optic Nerve/Sheath Biomechanics Simulations

Visual Impairment and Intracranial Pressure (VIIP) syndrome is a concern for long-duration space flight. Current thinking suggests that the ocular changes observed in VIIP syndrome are related to cephalad fluid shifts resulting in altered fluid pressures [1]. In particular, we hypothesize that increased intracranial pressure (ICP) drives connective tissue remodeling of the posterior eye and optic nerve sheath (ONS). We describe here finite element (FE) modeling designed to understand how altered pressures, particularly altered ICP, affect the tissues of the posterior eye and optic nerve sheath (ONS) in VIIP. METHODS: Additional description of the modeling methodology is provided in the companion IWS abstract by Feola et al. In brief, a geometric model of the posterior eye and optic nerve, including the ONS, was created and the effects of fluid pressures on tissue deformations were simulated. We considered three ICP scenarios: an elevated ICP assumed to occur in chronic microgravity, and ICP in the upright and supine positions on earth. Within each scenario we used Latin hypercube sampling (LHS) to consider a range of ICPs, ONH tissue mechanical properties, intraocular pressures (IOPs) and mean arterial pressures (MAPs). The outcome measures were biomechanical strains in the lamina cribrosa, optic nerve and retina; here we focus on peak values of these strains, since elevated strain alters cell phenotype and induce tissue remodeling. In 3D, the strain field can be decomposed into three orthogonal components, denoted as first, second and third principal strains. RESULTS AND CONCLUSIONS: For baseline material properties, increasing ICP from 0 to 20 mmHg significantly changed strains within the posterior eye and ONS (Fig. 1), indicating that elevated ICP affects ocular tissue biomechanics. Notably, strains in the lamina cribrosa and retina became less extreme as ICP increased; however, within the optic nerve, the occurrence of such extreme strains greatly increased as ICP was elevated (Fig. 2). In particular, c. 48 of simulations in the elevated ICP condition showed peak strains in the optic nerve that exceeded the strains expected on earth. Such extreme strains are likely important, since they represent a larger signal for mechano-responsive resident cells [2]. The models predicted little to no anterior motion of the prelaminar neural tissue (optic nerve swelling, or papilledema, secondary to axoplasmic stasis), typically seen with elevated ICP. Specialized FE models to capture axoplasmic stasis would be required to study papilledema. These results suggest that the most notable effect of elevated ICP may occur via direct optic nerve loading, rather than through connective tissue deformation. These FE models can inform the design of future studies designed to bridge the gap between biomechanics and pathophysiological function in VIIP.

biomechanics↗
NASA NTRS2018

Methods and Devices for Space Optical Communications Using Laser Beams

Light is used to communicate between objects separated by a large distance. Light beams are received in a telescopic lens assembly positioned in front of a cat's-eye lens. The light can thereby be received at various angles to be output by the cat's-eye lens to a focal plane of the cat's-eye lens, the position of the light beams upon the focal plane corresponding to the angle of the beam received. Lasers and photodetectors are distributed along this focal plane. A processor receives signals from the photodetectors, and selectively signal lasers positioned proximate the photodetectors detecting light, in order to transmit light encoding data through the cat's-eye lens and also through a telescopic lens back in the direction of the received light beams, which direction corresponds to a location upon the focal plane of the transmitting lasers.

Goorjian, Peter M.↗
NASA NTRSDate not supplied

Sensorimotor Predictors: Examining the Relationship Between Measures of Post-Landing Sensorimotor Functional Task Performance

Spaceflight drives adaptive changes in healthy individuals appropriate for sensorimotor function in a microgravity environment. These changes are maladaptive for return to Earth's gravity. The inter-individual variability of sensorimotor decrements is striking, although poorly understood. The goal of this study is to identify a set of behavioral, neuroimaging and genetic measures that can be used to predict early post-flight performance on sensorimotor functional tasks. To date, we have recruited fifteen astronauts who returned from the International Space Station on Soyuz and participated in sensorimotor field tests and/or posturography within one day following long-duration spaceflight. We are specifically utilizing a combination of three quantitative post-flight functional task outcomes(relative to pre-flight baselines): tandem walk, recovery from fall and dynamic posturography, along with a subjective self-rating of post-flight decrements and recovery. The recovery from fall is performed with eyes open on a stable support, allowing the use of vestibular, visual and proprioceptive feedback for task performance. In contrast, the dynamic posturography measures are performed with eyes closed on asway-referenced unstable support, requiring reliance on vestibular feedback for task performance. Tandem walk is performed on a stable surface with eyes open and eyes closed. Fourteen of the 15 subjects performed the field tests. These were nominally performed during three timepoints on the first postflight day, while posturography was performed only once during the third time point after direct return to JSC. More than 20% were unable to complete the initial field testing in the medical tent, while all participants completed testing during the third time point at JSC. As expected, there was considerable variability among all performance outcome measures, with more variability post-flight relative to preflight. Given the variability in all post-flight outcomes, we have been examining the relationships in performance across tasks. While there is a strong association within tests obtained at different landing daytime points, our preliminary findings suggest that by R+24 hrs performance on one post-flight test does not necessarily correlate with performance on other post-flight tests. This underscores the importance of a comprehensive post-flight test battery including different types of tasks with varying sensory feedback. We expect that further examining specific behavioral, neuroimaging and genetic sensorimotor biomarkers with post-flight functional task performance will improve both our understanding of the individual variability and our strategy to optimize sensorimotor countermeasures.

S J Wood↗
NASA NTRSDate not supplied

Sensorimotor Predictors: Examining the Relationship Between Measures of Post-Landing Sensorimotor Functional Task Performance

Spaceflight drives adaptive changes in healthy individuals appropriate for sensorimotor function in a microgravity environment. These changes are maladaptive for return to Earth's gravity. The inter-individual variability of sensorimotor decrements is striking, although poorly understood. The goal of this study is to identify a set of behavioral, neuroimaging and genetic measures that can be used to predict early post-flight performance on sensorimotor functional tasks. To date, we have recruited fifteen astronauts who returned from the International Space Station on Soyuz and participated in sensorimotor field tests and/or posturography within one day following long-duration spaceflight. We are specifically utilizing a combination of three quantitative post-flight functional task outcomes(relative to pre-flight baselines): tandem walk, recovery from fall and dynamic posturography, along with a subjective self-rating of post-flight decrements and recovery. The recovery from fall is performed with eyes open on a stable support, allowing the use of vestibular, visual and proprioceptive feedback for task performance. In contrast, the dynamic posturography measures are performed with eyes closed on asway-referenced unstable support, requiring reliance on vestibular feedback for task performance. Tandem walk is performed on a stable surface with eyes open and eyes closed. Fourteen of the 15 subjects performed the field tests. These were nominally performed during three timepoints on the first post flight day, while posturography was performed only once during the third time point after direct return to JSC. More than 20% were unable to complete the initial field testing in the medical tent, while all participants completed testing during the third time point at JSC. As expected, there was considerable variability among all performance outcome measures, with more variability post-flight relative to preflight. Given the variability in all post-flight outcomes, we have been examining the relationships in performance across tasks. While there is a strong association with in tests obtained at different landing daytime points, our preliminary findings suggest that by R+24 hrs performance on one post-flight test does not necessarily correlate with performance on other post-flight tests. This underscores the importance of a comprehensive post-flight test battery including different types of tasks with varying sensory feedback. We expect that further examining specific behavioral, neuroimaging and genetic sensorimotor biomarkers with post-flight functional task performance will improve both our understanding of the individual variability and our strategy to optimize sensorimotor countermeasures.

Yiri De Dios↗
NASA NTRS2026

Final Report Document: Microgravity Medical Eyewash B

Senior Capstone Design Team 15 has been commissioned by the National Aeronautics and Space Administration (NASA) to redesign the current microgravity eye wash station. The current design exhibits four primary limitations: single-use operation, excessive mass and volume, operational complexity requiring coordination with external systems, and dependence on frequent Earth resupply missions. Our updated eyewash design will be deployed on long-range space missions that could last multiple years. Based on these and other requirements from our customer, we have developed our updated eyewash design. Our compact, single-eye system uses capillary-driven flow and a free-floating water ball. This design allows us to eliminate pumps and bulky tubing, decreasing the mass and volume of the overall system. The containment eyecup is held to the astronaut's face with a strap, and a silicone seal prevents leakage while improving user comfort. Contaminated water is contained within a disposal bag containing wicking material to pull it back out of the eyecup after washing the eye. This system is reusable, efficient, and easy to activate quickly. We evaluated our design through calculations, microfluidic testing, and user try-on testing to verify our requirements. Our work demonstrated that steady-state flow was capable with our capillary framework, achieving 1.31 L/min. The prototype construction confirmed mass and volume reductions, and try-on-testing evaluated the ability to put on the system quickly. Almost all major design requirements were achieved, and water loss could be validated by testing in microgravity. Our design went through a number of iterations to reach the final solution presented in this report. These changes were driven by our testing and collaboration from each member of the team. Updated models optimized tube placement and geometry of the eyecup to better direct flow as it pools across the eye. Changes to our tubing bends improved capillary efficiency and increased the flow rate we were capable of achieving. And improved bracket placements adjusted the fit, comfort, and seal of the eyecup to the astronaut's face. Our capillary-based eyewash system is technically feasible and has been theoretically validated to operate effectively in microgravity conditions. Testing and analysis indicate that it can meet or exceed the required performance metrics, including flow rate and safety constraints. Overall, the design represents a viable alternative to current ISS-dependent eyewash systems for future space missions.

Jeffrey Allen↗
DOE OSTI2011

Neovascular Glaucoma After Stereotactic Radiotherapy for Juxtapapillary Choroidal Melanoma: Histopathologic and Dosimetric Findings

Purpose: Enucleation after stereotactic radiotherapy (SRT) for juxtapapillary choroidal melanoma may be required because of tumor progression (TP) or the development of intractable radiation-induced neovascular glaucoma (NVG). We compare pathologic changes and dosimetric findings in those eyes enucleated secondary to NVG as opposed to TP to better understand potential mechanisms. Methods and Materials: Patients with juxtapapillary choroidal melanoma treated with SRT (70 Gy in 5 fractions, alternate days over a total of 10 days) at the Princess Margaret Hospital, Toronto, Ontario, Canada, who underwent enucleation between 1998 and 2006 were selected. We correlated dosimetric data based on the patient's original SRT treatment plan with histopathologic findings in the retina, optic nerve head, and anterior chamber. A dedicated ocular pathologist reviewed each case in a blinded fashion. Results: Ten eyes in ten patients were enucleated after SRT. Six were enucleated secondary to NVG and four secondary to because of TP. Aggressive tumor features such as invasion of the sclera and epithelioid cell type were observed predominantly in the TP group. Retinal damage was more predominant in the NVG group, as were findings of radiation-related retinal vascular changes of fibrinoid necrosis and hyalinization. No conclusive radiation-related effects were found in the anterior chamber. The maximum point dose and dose to 0.1 cc were lower for the anterior chamber as compared with the dose to the tumor, retina, and optic nerve head. The mean 0.1-cc doses to the retina were 69.4 Gy and 73.5 Gy and to the anterior chamber were 4.9 Gy and 17.3 Gy for the NVG group and tumor progression group, respectively. Conclusions: Our findings suggest that NVG is due to radiation damage to the posterior chamber of the eye rather than primary radiation damage to the anterior segment.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2011

Preliminary Experience in Treatment of Papillary and Macular Retinoblastoma: Evaluation of Local Control and Local Complications After Treatment With Linear Accelerator-Based Stereotactic Radiotherapy With Micromultileaf Collimator as Second-Line or Salvage Treatment After Chemotherapy

Purpose: To determine the local control and complication rates for children with papillary and/or macular retinoblastoma progressing after chemotherapy and undergoing stereotactic radiotherapy (SRT) with a micromultileaf collimator. Methods and Materials: Between 2004 and 2008, 11 children (15 eyes) with macular and/or papillary retinoblastoma were treated with SRT. The mean age was 19 months (range, 2-111). Of the 15 eyes, 7, 6, and 2 were classified as International Classification of Intraocular Retinoblastoma Group B, C, and E, respectively. The delivered dose of SRT was 50.4 Gy in 28 fractions using a dedicated micromultileaf collimator linear accelerator. Results: The median follow-up was 20 months (range, 13-39). Local control was achieved in 13 eyes (87%). The actuarial 1- and 2-year local control rates were both 82%. SRT was well tolerated. Late adverse events were reported in 4 patients. Of the 4 patients, 2 had developed focal microangiopathy 20 months after SRT; 1 had developed a transient recurrence of retinal detachment; and 1 had developed bilateral cataracts. No optic neuropathy was observed. Conclusions: Linear accelerator-based SRT for papillary and/or macular retinoblastoma in children resulted in excellent tumor control rates with acceptable toxicity. Additional research regarding SRT and its intrinsic organ-at-risk sparing capability is justified in the framework of prospective trials.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2012

{sup 106}Ruthenium Plaque Therapy (RPT) for Retinoblastoma

Purpose: To evaluate the effectiveness of episcleral {sup 106}ruthenium plaque therapy (RPT) in the management of retinoblastoma. Methods and Materials: One hundred one RPTs were retrospectively analyzed that were performed in 90 eyes of 85 patients with retinoblastoma at National Cancer Center Hospital between 1998 and 2008. Each RPT had a corresponding tumor and 101 tumors were considered in the analysis of local control. Median follow-up length was 72.8 months. Median patient age at the RPT was 28 months. Median prescribed doses at reference depth and outer surface of the sclera were 47.4 Gy and 162.3 Gy, respectively. Results: Local control rate (LCR) and ocular retention rate (ORR) at 2 years were 33.7% and 58.7%, respectively. Unilateral disease, International Classification of Retinoblastoma group C or more advanced at the first presentation or at the time of RPT, vitreous and/or subretinal seeding, tumor size greater than 5 disc diameter (DD), reference depth greater than 5 mm, dose rate at reference depth lower than 0.7 Gy/hour, dose at the reference depth lower than 35 Gy, and (biologically effective dose with an {alpha}/{beta} ratio of 10 Gy) at the reference depth lower than 40 Gy{sub 10} were associated with unfavorable LCR. Two patients died of metastatic disease. Radiation complications included retinal detachment in 12 eyes (13.3%), proliferative retinopathy in 6 (6.7%), rubeosis iris in 2 (2.2%), and posterior subcapsular cataract in 23 (25.6%). Conclusion: RPT is an effective eye-preserving treatment for retinoblastoma.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2012

Risk of Radiation Retinopathy in Patients With Orbital and Ocular Lymphoma

Purpose: Radiation retinopathy is a potential long-term complication of radiation therapy to the orbit. The risk of developing this adverse effect is dose dependent; however, the threshold is unclear. The aim of this study was to identify the risk of developing radiation retinopathy at increasing radiation doses. Methods and Materials: A 40-year retrospective review was performed of patients who received external beam radiation therapy for ocular/orbital non-Hodgkin lymphoma (NHL). Results: Sixty-seven patients who had at least one ophthalmic follow-up examination were included in this study. Most patients (52%) were diagnosed with NHL involving the orbit. Patients received external beam radiation therapy at doses between 1886 and 5400 cGy (mean, 3033 {+-} 782 cGy). Radiation retinopathy developed in 12% of patients, and the median time to diagnosis was 27 months (range, 15-241months). The mean prescribed radiation dose in patients with retinopathy was 3309 {+-} 585 cGy, and the estimated retinal dose (derived by reviewing the dosimetry) was 3087 {+-} 1030 cGy. The incidence of retinopathy increased with dose. The average prescribed daily fractionated dose was higher in patients who developed retinopathy than in patients who did not (mean, 202 cGy vs 180 cGy, respectively; P = .04). More patients with radiation retinopathy had comorbid diabetes mellitus type 2 than patients without retinopathy (P = .015). In our study, the mean visual acuity of the eyes that received radiation was worse than that of the eyes that did not (P = .027). Other postradiotherapy ocular findings included keratitis (6%), dry eyes (39%), and cataract (33%). Conclusions: Radiation retinopathy, a known complication of radiotherapy for orbital tumors, relates to vascular comorbidities and dose. Higher total doses and larger daily fractions (>180 cGy) appear to be related to higher rates of retinopathy. Future larger studies are required to identify a statistically significant threshold for the development of retinopathy.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2015

Long-term Results of the UCSF-LBNL Randomized Trial: Charged Particle With Helium Ion Versus Iodine-125 Plaque Therapy for Choroidal and Ciliary Body Melanoma

Purpose: Relevant clinical data are needed given the increasing national interest in charged particle radiation therapy (CPT) programs. Here we report long-term outcomes from the only randomized, stratified trial comparing CPT with iodine-125 plaque therapy for choroidal and ciliary body melanoma. Methods and Materials: From 1985 to 1991, 184 patients met eligibility criteria and were randomized to receive particle (86 patients) or plaque therapy (98 patients). Patients were stratified by tumor diameter, thickness, distance to disc/fovea, anterior extension, and visual acuity. Tumors close to the optic disc were included. Local tumor control, as well as eye preservation, metastases due to melanoma, and survival were evaluated. Results: Median follow-up times for particle and plaque arm patients were 14.6 years and 12.3 years, respectively (P=.22), and for those alive at last follow-up, 18.5 and 16.5 years, respectively (P=.81). Local control (LC) for particle versus plaque treatment was 100% versus 84% at 5 years, and 98% versus 79% at 12 years, respectively (log rank: P=.0006). If patients with tumors close to the disc (<2 mm) were excluded, CPT still resulted in significantly improved LC: 100% versus 90% at 5 years and 98% versus 86% at 12 years, respectively (log rank: P=.048). Enucleation rate was lower after CPT: 11% versus 22% at 5 years and 17% versus 37% at 12 years, respectively (log rank: P=.01). Using Cox regression model, likelihood ratio test, treatment was the most important predictor of LC (P=.0002) and eye preservation (P=.01). CPT was a significant predictor of prolonged disease-free survival (log rank: P=.001). Conclusions: Particle therapy resulted in significantly improved local control, eye preservation, and disease-free survival as confirmed by long-term outcomes from the only randomized study available to date comparing radiation modalities in choroidal and ciliary body melanoma.

62 RADIOLOGY AND NUCLEAR MEDICINE↗
DOE OSTI2016

Practice Patterns Analysis of Ocular Proton Therapy Centers: The International OPTIC Survey

Purpose: To assess the planning, treatment, and follow-up strategies worldwide in dedicated proton therapy ocular programs. Methods and Materials: Ten centers from 7 countries completed a questionnaire survey with 109 queries on the eye treatment planning system (TPS), hardware/software equipment, image acquisition/registration, patient positioning, eye surveillance, beam delivery, quality assurance (QA), clinical management, and workflow. Results: Worldwide, 28,891 eye patients were treated with protons at the 10 centers as of the end of 2014. Most centers treated a vast number of ocular patients (1729 to 6369). Three centers treated fewer than 200 ocular patients. Most commonly, the centers treated uveal melanoma (UM) and other primary ocular malignancies, benign ocular tumors, conjunctival lesions, choroidal metastases, and retinoblastomas. The UM dose fractionation was generally within a standard range, whereas dosing for other ocular conditions was not standardized. The majority (80%) of centers used in common a specific ocular TPS. Variability existed in imaging registration, with magnetic resonance imaging (MRI) rarely being used in routine planning (20%). Increased patient to full-time equivalent ratios were observed by higher accruing centers (P=.0161). Generally, ophthalmologists followed up the post–radiation therapy patients, though in 40% of centers radiation oncologists also followed up the patients. Seven centers had a prospective outcomes database. All centers used a cyclotron to accelerate protons with dedicated horizontal beam lines only. QA checks (range, modulation) varied substantially across centers. Conclusions: The first worldwide multi-institutional ophthalmic proton therapy survey of the clinical and technical approach shows areas of substantial overlap and areas of progress needed to achieve sustainable and systematic management. Future international efforts include research and development for imaging and planning software upgrades, increased use of MRI, development of clinical protocols, systematic patient-centered data acquisition, and publishing guidelines on QA, staffing, treatment, and follow-up parameters by dedicated ocular programs to ensure the highest level of care for ocular patients.

62 RADIOLOGY AND NUCLEAR MEDICINE↗