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t m c » p u l s e | j u ly 2 0 1 7 33 Relieving the Pressure NASA technology will help eye patients on Earth and in space T he same technology that allows NASA to identify minerals on the surface of Mercury is being adapted to diagnose eye conditions on Earth. Multispectral imaging (MSI) gathers information across the electro- magnetic spectrum. Different surfaces absorb different amounts of light, so MSI captures data in varying wave- lengths that can be separated by filters beyond the visible light range. These images provide NASA with information about water, vegetation, soil and the atmosphere on other planets. Now, local neuro-ophthalmologists Rosa Tang, M.D., and Jade Schiffman, M.D., co-directors at The Optic Nerve Center—a unit of Neuro- Ophthalmology of Texas, in the Eye Wellness Center—are studying the effectiveness of MSI in identifying a number of eye conditions. Their NASA-funded study, led by Baylor College of Medicine's Eric Bershad, M.D., examines eye conditions that astronauts may develop in space. Tang and Schiffman focused on idiopathic intercranial hypertension (IIH), a condition in which pressure increases in the spaces surrounding the brain and spinal cord. IIH is most common in overweight women of child- bearing age, and the increased pressure from IIH can lead to papilledema, a swelling of the optic nerve. Symptoms of papilledema include disturbances in vision, vomiting and headaches. In some papilledema cases, the ret- ina and choroid—the vascular layer of the eye that contains connective tissue and provides all eye layers with most of their blood supply—may develop folds. The depth of the MSI imaging allows doctors to see the choroid and any potential trouble spots. Over three months, Tang and Schiffman evaluated about 90 patients using MSI and other imaging devices. MSI reliably imaged the optic nerve swelling and the choroidal folds in these patients, and a preliminary analysis suggests that MSI provided a unique view of the choroid not seen with other imaging devices. In a healthy eye, the layers within the choroid look like a smooth ocean; if there are folds in the choroid, the layers look like waves. "Previously, our imaging stayed in the layer of the retina and we could not image deeper into the choroidal layer," Tang said. "Now, we can pene- trate into that area more reliably and see the folds." For decades, medical researchers have found that NASA technology complements their own work. In the 1980s, for example, Houston Methodist heart surgeons Michael E. DeBakey, M.D., and George Noon, M.D., created an implantable heart pump that was inspired, in part, by the way a space shuttle engine operates. More recently, Susan Love, M.D., clinical professor of surgery at the David Geffen School of Medicine at UCLA, was reported to be using technology from NASA's Jet Propulsion Laboratory to study the microbiome of breast ducts, a likely origin for breast cancers. While Tang and Schiffman are determining the usefulness of MSI in studying eye conditions on Earth, they hope the same technology will be effective in detecting eye conditions in space, specifically microgravity ocular syndrome. This syndrome also results in papilledema, and NASA wants to be able to diagnose it while astronauts are in space. Though microgravity ocular syndrome causes similar symptoms to IIH, Tang said, it is interesting to researchers that fit astronauts develop it in space, while IIH tends to affect overweight or obese individuals here on Earth. "If we can learn when exactly the microgravity ocular syndrome develops in the astronauts in space, potentially the cause and prevention may be determined," she said. 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