Hypoxia, even mild, is known to produce negative effects on visual function, including decreased visual acuity and sensitivity to contrast, mostly in low light. This is of special concern when night vision devices (NVDs) are used during flight because they also provide poor images in terms of resolution and contrast.
While wearing NVDs in low light conditions, 16 healthy male aviators were exposed to a simulated altitude of 12,500 ft in a hypobaric chamber.
Snellen visual acuity decreased in normal light from 28.5 +/- 4.2/20 (normoxia) to 37.2 +/- 7.4/20 (hypoxia) and, in low light, from 33.8 +/- 6.1/20 (normoxia) to 42.2 +/- 8.4/20 (hypoxia), both at a significant level. An association was found between blood oxygen saturation and visual acuity without significance. No changes occurred in terms of sensitivity to contrast.
Our data demonstrate that mild hypoxia is capable of affecting visual acuity and the photopic/high mesopic range of NVD-aided vision. This may be due to several reasons, including the sensitivity to hypoxia of photoreceptors and other retinal cells. Contrast sensitivity is possibly preserved under NVD-aided vision due to its dependency on the goggles' gain.
[Show abstract][Hide abstract] ABSTRACT: To investigate the effect of very high altitude and different ascent profiles on central corneal thickness (CCT).
Twenty-eight healthy mountaineers were randomly assigned to 2 different ascent profiles during a medical research expedition to Mount Muztagh Ata (7546 m) in western China. Group 1 was allotted a shorter acclimatization time prior to ascent to 6265 m. The main outcome measure was CCT. Secondary outcome measures were oxygen saturation (SpO(2)) and symptom assessments of acute mountain sickness (cerebral acute mountain sickness score). Examinations were performed at 490, 4497, 5533, and 6265 m.
Central corneal thickness increased in both groups with increasing altitude and decreased after descent. In group 1 (with the shorter acclimatization), mean CCT increased from 537 to 572 microm. Mean CCT in group 2 increased from 534 to 563 microm (P = .048). The amount of decrease in SpO(2) paralleled the increase in CCT. There was no significant decrease in visual acuity. There was a significant correlation between CCT and cerebral acute mountain sickness score when controlled for SpO(2) and age.
Corneal swelling during high-altitude climbs is promoted by low SpO(2). Systemic delivery of oxygen to the anterior chamber seems to play a greater role in corneal oxygenation than previously thought. Adhering to a slower ascent profile results in less corneal edema. Visual acuity in healthy corneas is not adversely affected by edema at altitudes of up to 6300 m. Individuals with more acute mountain sickness-related symptoms had thicker corneas, possibly due to their higher overall susceptibility to hypoxia.
Archives of ophthalmology 02/2010; 128(2):184-9. DOI:10.1001/archophthalmol.2009.385 · 4.40 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Visual performance in dim light is compromised by lack of oxygen (hypoxia). The possible influence of altered oxygenation on foveal contrast sensitivity under mesopic (twilight) viewing conditions is relevant to aircrew flying at night, including when using night vision devices, but is poorly documented.
Foveal contrast sensitivity was measured binocularly and monocularly in 12 subjects at 7 spatial frequencies, ranging from 0.5 to approximately 16 cycles per degree, using sinusoidal Gabor patch gratings. Hypoxic performance breathing 14.1% oxygen, equivalent to altitude exposure at 3048 m (10,000 ft), was compared with breathing air at sea level (normoxia) at low photopic (28 cd x m(-2)), borderline upper mesopic (approximately 2.1 cd x m(-2)) and midmesopic (approximately 0.26 cd x m(-2)) luminance. Mesopic performance was also assessed breathing 100% oxygen (hyperoxia).
Typical 'inverted U' log/log plots of the contrast sensitivity function were obtained, with elevated thresholds (reduced sensitivity) at lower luminance. Binocular viewing enhanced sensitivity by a factor approximating square root of 2 for most conditions, supporting neural summation of the contrast signal, but had greater influence at the lowest light level and highest spatial frequencies (8.26 and 16.51 cpd). Respiratory challenges had no effect.
Contrast sensitivity is poorer when viewing monocularly and especially at midmesopic luminance, with relevance to night flying. The foveal contrast sensitivity function is unaffected by respiratory disturbance when twilight conditions favor cone vision, despite known effects on retinal illumination (pupil size). The resilience of the contrast sensitivity function belies the vulnerability of foveal low contrast acuity to mild hypoxia at mesopic luminance.
Aviation Space and Environmental Medicine 05/2010; 81(5):475-83. DOI:10.3357/ASEM.2728.2010 · 0.88 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The effect of mild hypoxia on chromatic sensitivity in the mesopic range is poorly documented. This study was conducted to examine the effects of mild hypoxia and hyperoxia on red-green (R-G) and yellow-blue (Y-B) chromatic sensitivity thresholds at low photopic (22.3 cd . m(-2)), borderline upper mesopic (1.67 cd . m(-2)) and mid-mesopic (0.21 cd . m(-2)) luminance.
The Color Assessment and Diagnosis (CAD) test was used to measure binocular and monocular R-G and Y-B chromatic sensitivity by using dynamic luminance contrast noise to isolate the use of color signals. Mild hypoxia was imposed by breathing 14.1% oxygen and was investigated relative to control exposures breathing air (normoxia) at each light level. Subsequently, hyperoxia, breathing 100% oxygen, was assessed relative to hypoxia under the mesopic conditions. A balanced, repeated-measures design allowed assessment of main effects and interactions of light level, viewing condition, gender, breathing gas, and exposure order by using multivariate analysis of variance (MANOVA), with post hoc analysis employing ANOVA and paired t-tests.
Light level, number of viewing eyes, and oxygenation state were significant determinants of chromatic sensitivity. One man and one woman introduced orthogonal sources of gender bias. The CAD test revealed minimal deuteranomaly (R-G deficiency) in the man and loss of Y-B sensitivity in the only woman using hormonal contraception.
In the mesopic range, mild hypoxia impairs chromatic sensitivity progressively with reducing luminance. Binocular summation of chromatic signals is consistent and independent of the luminance channel. The CAD test is highly sensitive to mild congenital and acquired color vision deficiencies.
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