■在飞行或类似活动中暴露于高空条件会影响视觉功能的许多方面,这不仅对飞行安全至关重要,对任何与海拔相关的活动也至关重要。我们旨在总结有关飞行或等效短期高空暴露期间眼部变化的可用文献(例如,低压舱,毫不费力的上升持续≤24小时),并强调未来的研究重点。
■使用具有结构化搜索语法的PubMed/MEDLINE和WebofScience/ISIWebofKnowledge数据库,我们对40年(1983年1月1日至2023年10月10日)的文献进行了系统回顾.检索了有关飞行过程中眼睛变化或飞行等效暴露于高度的文章。还搜索了检索到的研究的参考列表,这些参考文献的引文包括在结果中。
■在875种相关PubMed和ISI出版物中,122个符合纳入条件,从最初选定的记录的参考列表中检索到20个以上,共142条。报告的眼前节变化包括泪膜稳定性恶化和干眼发生率增加,角膜厚度增加,隐形眼镜使用者的不适和气泡形成,先前进行屈光手术的个体的屈光变化,眼内压降低,和瞳孔反应的改变,对比敏感度,和视野。光感受器-视觉通路的变化包括光感受器和神经传导的改变,正如在黑暗适应中所证明的那样,黄斑恢复时间,视野灵敏度降低,和视神经炎(可能是减压病的因素)。视网膜脉络膜改变包括视网膜血管口径增加,视网膜血流,和脉络膜厚度;中心性浆液性脉络膜视网膜病变;和视网膜血管事件(非动脉炎性缺血性视神经病变,高海拔视网膜病变,和视网膜静脉阻塞)。
■短期高海拔暴露对眼睛的影响是,本身,一个很难研究的领域。尽管视力严重受损似乎很少见,眼部变化,包括泪膜稳定性,隐形眼镜磨损,中央角膜厚度,眼内压,对比敏感度,屈光手术的稳定性,视网膜血管,视野,和黄斑恢复时间,应该在民用飞行员中考虑。我们的报告为登山者和低地人提供了指导,如果他们有预先存在的眼部疾病或在高海拔时出现视觉症状。然而,关键结果相互矛盾,缺乏全面的研究,尤其是那些与脉络膜和视网膜有关的.这样的研究不仅可以加深我们对高原眼部病理生理学的认识,但也可以为一系列其他视力威胁疾病提供有价值的信息和治疗可能性。
UNASSIGNED: Exposure to high-altitude conditions during flight or similar activities affects many aspects of visual function, which is critical not only for flight safety but for any altitude-related activity. We aimed to summarize the available literature pertaining to ocular changes during flight or equivalent short-term high-altitude exposure (e.g., hypobaric chamber, effortless ascent lasting ≤ 24 h) and to highlight future research priorities.
UNASSIGNED: Using the PubMed/MEDLINE and Web of Science/ISI Web of Knowledge databases with structured search syntax, we conducted a systematic review of the literature spanning a 40-year period (January 1, 1983, to October 10, 2023). Articles pertaining to ocular changes during flight or flight-equivalent exposure to altitude were retrieved. The reference lists of retrieved studies were also searched, and citations of these references were included in the results.
UNASSIGNED: Of 875 relevant PubMed and ISI publications, 122 qualified for inclusion and 20 more were retrieved from the reference lists of initially selected records, for a total of 142 articles. Reported anterior segment changes included deterioration in tear film stability and increased dry eye incidence, increased corneal thickness, discomfort and bubble formation in contact lens users, refraction changes in individuals with prior refractive surgery, decreased intraocular pressure, and alterations in pupillary reaction, contrast sensitivity, and visual fields. Photoreceptor-visual pathway changes included alterations in both photoreceptors and neuro-transduction, as evidenced in dark adaptation, macular recovery time, reduction in visual field sensitivity, and optic neuritis (likely an element of decompression sickness). Retinochoroidal changes included increases in retinal vessel caliber, retinal blood flow, and choroidal thickness; central serous chorioretinopathy; and retinal vascular events (non-arteritic ischemic optic neuropathy, high-altitude retinopathy, and retinal vein occlusion).
UNASSIGNED: The effect of short-term high-altitude exposure on the eye is, in itself, a difficult area to study. Although serious impairment of visual acuity appears to be rare, ocular changes, including tear film stability, contact lens wear, central corneal thickness, intraocular pressure, contrast sensitivity, stability of refractive surgeries, retinal vessels, visual fields, and macula recovery time, should be considered in civilian aviators. Our report provides guidance to climbers and lowlanders traveling to altitude if they have pre-existing ocular conditions or if they experience visual symptoms while at altitude. However, key outcomes have been contradictory and comprehensive studies are scarce, especially those pertaining to the choroid and retina. Such studies could not only deepen our understanding of high-altitude ocular pathophysiology, but could also offer valuable information and treatment possibilities for a constellation of other vision-threatening diseases.