Joshua Ong

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Verified

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• Doctor of Medicine
• Resident Physician at University of Michigan

The neuro-ocular effects of long-duration spaceflight have been termed Spaceflight Associated Neuro-Ocular Syndrome (SANS) and are a potential challenge for future, human space exploration. The underlying pathogenesis of SANS remains ill-defined, but several emerging translational applications of terrestrial head-mounted, visual assessment technolo...

During long-duration spaceflight, astronauts are exposed to various risks including spaceflight-associated neuro-ocular syndrome, which serves as a risk to astronaut vision and a potential physiological barrier to future spaceflight. When considering exploration missions that may expose astronauts to longer periods of microgravity, radiation exposu...

Spaceflight associated neuro-ocular syndrome (SANS) refers to a distinct constellation of ocular, neurological and neuroimaging findings observed in astronauts during and following long duration spaceflight. These ocular findings, to include optic disc oedema, posterior globe flattening, chorioretinal folds and hyperopic shifts, were first describe...

Purpose To provide automated system for synthesizing fluorescein angiography (FA) images from color fundus (CF) photographs for averting risks associated with fluorescein dye and extend its future application to Space-associated neuro-ocular syndrome (SANS) detection in spaceflight where resources are limited. Design Development and validation of a...

The ability to make on-field, split-second decisions is critical for National Football League (NFL) game officials. Multiple principles in visual function are critical for accuracy and precision of these play calls, including foveation time and unobstructed line of sight, static visual acuity, dynamic visual acuity, vestibulo-ocular reflex, and suf...

The rapid evolution of deep learning has dramatically enhanced the field of medical image segmentation, leading to the development of models with unprecedented accuracy in analyzing complex medical images. Deep learning-based segmentation holds significant promise for advancing clinical care and enhancing the precision of medical interventions. How...

Integrating artificial intelligence (AI) and mixed reality (MR) into orthopedic education has transformed learning. This review examines AI-powered platforms like Microsoft HoloLens, Apple Vision Pro, and HTC Vive Pro, which enhance anatomical visualization, surgical simulation, and clinical decision-making. These technologies improve the spatial u...

The integration of artificial intelligence (AI) into musculoskeletal and ocular diagnostics has catalyzed a paradigm shift in precision medicine, enabling the detection of subclinical correlations between ocular biomarkers and systemic musculoskeletal pathologies. Convolutional neural networks (CNNs) and multimodal imaging platforms are poised to d...

Orthopedic trauma remains a critical challenge in modern healthcare, often resulting in severe mobility limitations, acute pain, and delayed recovery. Conventional rehabilitation techniques, though effective, fail to address the individualized, high-precision interventions needed for musculoskeletal injuries like fractures, joint instability, ligam...

Purpose Generative adversarial networks (GANs) are key components of many artificial intelligence (AI) systems that are applied to image-informed bioengineering and medicine. GANs combat key limitations facing deep learning models: small, unbalanced datasets containing few images of severe disease. The predictive capacity of conditional GANs may al...

Refractive error is among the leading causes of visual impairment globally. The diagnosis and management of refractive error has traditionally relied on comprehensive eye examinations by eye care professionals, but access to these specialized services has remained limited in many areas of the world. Given this, artificial intelligence (AI) has show...

Artificial Intelligence (AI) is revolutionizing the field of orthopedic bioengineering by increasing diagnostic accuracy and surgical precision and improving patient outcomes. This review high-lights using AI for orthopedics in preoperative planning, intra-operative robotics, smart implants, and bone regeneration. AI-powered imaging, automated 3D a...

Human space exploration presents an unparalleled opportunity to study life in extreme environments—but it also exposes astronauts to physiological stressors that jeopardize key systems like vision. Corneal health, essential for maintaining precise visual acuity, is threatened by microgravity-induced fluid shifts, cosmic radiation, and the confined...

Integrating artificial intelligence (AI) and mixed reality (MR) into orthopedic education has transformed learning. This review examines AI-powered platforms like Microsoft HoloLens, Apple Vision Pro, and HTC Vive Pro, which enhance anatomical visualization, surgical simulation, and clinical decision-making. These technologies improve spatial under...

In this Matters Arising, we critically examine the data processing and computational challenges highlighted under the high-resolution, three-dimensional reconstruction of human cortical tissue by Shapson-Coe et al. While the study represents a technical milestone in connectomics, involving a 1.4-petabyte dataset derived from mapping a cubic millime...

Spaceflight presents unique challenges to ocular health which must be addressed when considering future long-term missions to Mars and beyond, specifically with increased risk to the anterior segment of the eye. While the posterior segment has been heavily researched via examinations with Heidelberg’s Spectralis Optical Coherence Tomography (OCT)2...

In light of the potential effects of spaceflight on the anterior segment of the eye, there is a pressing need for anterior segment imaging to be available and accessible to monitor astronauts’ ocular health, including alterations to the cornea and lens. We aim to highlight the clinical basis and need for anterior segment imaging for astronauts. We...

In February 1968, NASA purchased 400 antigravity ballpoint pens from the Fisher Pen Company for the Apollo Program to prevent potential harm to astronauts and equipment. Mechanical pencils previously used in microgravity posed risks like eye injuries from floating fragments penetrating the cornea. The cornea is vulnerable to abrasions, perforations...

Oculomics is an emerging field that leverages ophthalmic imaging data to identify biomarkers of systemic disease, facilitating early diagnosis and risk stratification. Despite its growing recognition, gaps remain in the literature regarding the clinical applications of oculomics. Various systemic diseases—including metabolic disorders (e.g., diabet...

The eye provides novel insights into general health, as well as pathogenesis and development of systemic diseases. In the past decade, growing evidence has demonstrated that the eye's structure and function mirror multiple systemic health conditions, especially in cardiovascular diseases, neurodegenerative disorders, and kidney impairments. This ha...

Ophthalmic diseases such as glaucoma, age-related macular degeneration (ARMD), and optic neuritis involve complex molecular and cellular disruptions that challenge current diagnostic and therapeutic approaches. Advanced artificial intelligence (AI) and machine learning (ML) models offer a novel lens to analyze these diseases by integrating diverse...

Astronauts can develop a distinct collection of neuro-ophthalmic findings during long duration spaceflight, collectively known as Spaceflight Associated Neuro-ocular Syndrome (SANS). These clinical characteristics include optic disc edema, hyperopic refractive shifts, globe flattening, and chorioretinal folds, which may pose a health risk for futur...

Pupillometry is an emerging, noninvasive technique that measures pupil reactivity and provides deeper insights into ophthalmic and neurologic function. Extended reality (XR) technology has also emerged with powerful clinical capabilities in various medical specialties, particularly in neuro-ophthalmology functional testing. This article explores th...

Vision-threatening conditions, such as age-related macular degeneration (AMD) and central serous chorioretinopathy (CSCR), arise from dysfunctions in the highly vascular choroid layer in the eye’s posterior segment. Optical coherence tomography (OCT) images play a crucial role in diagnosing choroidal structural changes in clinical practice. This re...

The National Aeronautics and Space Administration (NASA) in the United States has been studying a fascinating and unique constellation of neuro-ophthalmic findings collectively known as Spaceflight Associated Neuro-Ocular Syndrome (SANS). SANS is unique to the space environment of microgravity and produces novel physiological and pathological findi...

Advancements in neuroimaging, particularly diffusion magnetic resonance imaging (MRI) techniques and molecular imaging with positron emission tomography (PET), have significantly enhanced the early detection of biomarkers in neurodegenerative and neuro-ophthalmic disorders. These include Alzheimer’s disease, Parkinson’s disease, multiple sclerosis,...

Visual processing involves numerous neuro-ophthalmic pathways that enable humans to perceive and interact with the world. These visual pathways can negatively impact visual perception and decision-making. The Vestibulo-Ocular Reflex (VOR) is a compensatory mechanism that stabilizes gaze on a target during head movement, such as running or turning....

The spaceflight environment introduces unique and diverse changes to the ophthalmic system. The neuro-ophthalmic phenomenon, spaceflight-associated neuro-ocular syndrome (SANS), has been identified as one of the largest physiologic barriers to future crewed long-duration spaceflight. Although one of the largest barriers, the underlying pathogenesis...

Advancements in neuroimaging, particularly diffusion MRI techniques and molecular imaging via PET, have significantly improved our ability to detect early biomarkers of both neurodegenerative and neuro-ophthalmic disorders, such as Alzheimer's, Parkinson's, multiple sclerosis (MS), neuromyelitis optica (NMO), and myelin oligodendrocyte glycoprotein...

Purpose of review Spaceflight-associated neuro-ocular syndrome (SANS) encompasses a unique constellation of neuro-ocular findings in astronauts, including optic disc edema (ODE), globe flattening, chorioretinal folds, and hyperopic refractive shift. Although there are numerous neuro-ocular findings in SANS, the purpose of this review is to describe...

This review examines recent advancements and persistent challenges in corticospinal tract (CST) visualization, highlighting its critical role in motor function assessment and neurosurgical planning. Despite improvements in imaging techniques, CST visualization continues to face issues related to variability in imaging protocols, data processing met...

Retinal conditions like age-related macular degeneration (AMD), diabetic retinopathy, central serous chorioretinopathy (CSCR), and retinal vein occlusion can drastically affect a patient’s quality of life [...]

Purpose To analyse the longitudinal changes in imaging parameters in eyes with acute or chronic central serous chorioretinopathy (CSCR). Methods This was a multicentric, retrospective, longitudinal, observational study in patients with a diagnosis of CSCR and having at least 4 years of follow-up. Trend in choroidal thickness (CT), area of double l...

Outer space is an austere environment filled with unique and potentially dangerous stressors that can impact the physiologic function of astronauts during and after their stay above the atmosphere. Within 24 hours of flight, astronauts may experience nausea and malaise, coined space motion sickness, due to vestibular and ocular sensory mismatch and...

Corneal diseases represent a growing public health burden, especially in resource-limited settings lacking access to specialized eye care. Artificial intelligence (AI) offers promising solutions for automating the diagnosis and management of corneal conditions. This narrative review examines the application of AI in corneal diseases, focusing on ke...

Crewed spaceflight missions require careful scrutinization of the physiologic andpathologic risks including alterations to the tear film lipid layer in astronauts. We review thecurrent literature and prior published work on tear film lipid layer biophysics and secondaryspaceflight-associated dry eye syndrome (SADES). Our review covers the ocular su...

Glaucoma is a leading cause of irreversible blindness worldwide and poses a significant public health challenge. Primary open-angle glaucoma (POAG) is the most common form of glaucoma and is marked by progressive optic nerve damage and peripheral visual field loss. Early detection and management of glaucoma are essential to prevent severe vision im...

With increasing space exploration, there is a rising need to evaluate the impact of spaceflight on astronauts’ health, including the effects of space-associated hazards such as microgravity. Astronauts’ reports of experienced symptoms upon spaceflight include a notable prevalence of dry eye disease (DED). Hence, there is a pressing need to understa...

PURPOSE: Characterize geographical trends in ophthalmology research between 2002 and 2022 and explore associations among study locations, designs, and funding sources DESIGN: Trend study. METHODS: Analysis of 4199 publications from the American Journal of Ophthalmology, British Journal of Ophthalmology, Investigative Ophthalmology & Visual Scienc...

Multiple Sclerosis (MS) is a chronic autoimmune demyelinating disease of the central nervous system (CNS) characterized by inflammation, demyelination, and axonal damage. Early recognition and treatment are important for preventing or minimizing the long-term effects of the disease. Current gold standard modalities of diagnosis (e.g., CSF and MRI)...

The complement cascade is a vital system in the human body’s defense against pathogens. During the natural aging process, it has been observed that this system is imperative for ensuring the integrity and homeostasis of the retina. While this system is critical for proper host defense and retinal integrity, it has also been found that dysregulation...

Long-duration spaceflight (LDSF) is associated with unique hazards and linked with numerous human health risks including Spaceflight Associated Neuro-ocular Syndrome (SANS). The proposed mechanisms for SANS include microgravity induced cephalad fluid shift and increased Intracranial Pressure (ICP). SANS is a disorder seen only after LDSF and has no...

The negative impact of climate change on human health is well documented but under-recognized (e.g., air pollution, malnutrition, water-source contamination, and altered vector and waterborne transmission of infectious disease). The impact of climate change on eye health remains significantly underappreciated, whereas climate change impacts every c...

As spaceflight becomes increasingly accessible and expansive to humanity, it is becoming ever more essential to consider the treatment of various eye diseases in these challenging environments. This paper delves into the increasing fascination with interplanetary travel and its implications for health management in varying environments. It specific...

Generative AI has revolutionized medicine over the past several years. A generative adversarial network (GAN) is a deep learning framework that has become a powerful technique in medicine, particularly in ophthalmology and image analysis. In this paper we review the current ophthalmic literature involving GANs, and highlight key contributions in th...

Purpose: To determine if a neuro-ophthalmic curriculum would improve National Football League (NFL) game officials’ self-rated knowledge and interest in neuro-ophthalmic principles to improve precision and accuracy of NFL play-calling. Design: Quality Improvement Project Participants: NFL Game Officials, Replay Officials, and Staff Methods: The for...

Background Applications for artificial intelligence (AI) in ophthalmology are continually evolving. Fundoscopy is one of the oldest ocular imaging techniques but remains a mainstay in posterior segment imaging due to its prevalence, ease of use, and ongoing technological advancement. AI has been leveraged for fundoscopy to accomplish core tasks inc...

Embarking on long-duration spaceflights with limited resources and absence of immediate medical facilities necessitates careful consideration of potential health hazards in the unforgiving confines of space. Among the extensive possible risks inherent in space exploration, ocular injuries [1,2,3], particularly corneal thermal burns, stand out as si...

Early involvement and exposure to evidence-based research during medical school have been shown to play a formative role in students’ holistic development as future physicians. While there are medical schools encouraging research initiatives, few programs implement 4-year longitudinal research in the curriculum. Here, the authors categorized gradua...

Over the past several years, Artificial intelligence (AI) has rapidly emerged as a tool to help revolutionize the field of medicine, offering solutions to improve healthcare delivery and research. Sora is a cutting-edge AI model that can generate realistic and imaginative scenes based on text input, thus leveraging advancements in machine learning...

Open AI’s Sora represents a ground-breaking innovation in AI that can generate lifelike and imaginative visual scenes based on text prompts. However, Sora has also produced some new concerns surrounding artificial video generation in medicine. While Sora is highly promising to enhance patient education, facilitate remote consultations and simulate...

Lower Body Negative Pressure (LBNP) redistributes blood from the upper body to the lower body. LBNP may prove to be a countermeasure for the multifaceted physiological changes endured by astronauts during spaceflight related to cephalad fluid shift. Over more than five decades, beginning with the era of Skylab, advancements in LBNP technology have...

With plans for future long-duration crewed exploration, NASA has identified several high priority potential health risks to astronauts in space. One such risk is a collection of neurologic and ophthalmic findings termed spaceflight associated neuro-ocular syndrome (SANS). The findings of SANS include optic disc edema, globe flattening, retinal nerv...

Dry eye syndrome (DES) poses a significant challenge for astronauts during space missions, with reports indicating up to 30% of International Space Station (ISS) crew members. The microgravity environment of space alters fluid dynamics, affecting distribution of fluids on the surface of the eye as well as inducing cephalad fluid shifts that can alt...

Spaceflight associated neuro-ocular syndrome (SANS) is one of the largest physiologic barriers to spaceflight and requires evaluation and mitigation for future planetary missions. As the spaceflight environment is a clinically limited environment, the purpose of this research is to provide automated, early detection and prognosis of SANS with a mac...

Introduction During interplanetary spaceflight, brief periods of extreme gravitational transition are anticipated to occur between hypogravity, microgravity and hypergravity. These G-transition events may affect astronaut mission performance including dynamic visual acuity and gaze control.1,2 Significant impairments in dynamic visual acuity (DVA)...

Ocular health is currently a major concern for astronauts on current and future long-duration spaceflight missions. Spaceflight-associated neuro-ocular syndrome (SANS) is a collection of ophthalmic and neurologic findings that is one potential physiologic barrier to interplanetary spaceflight. Since its initial report in 2011, our understanding of...

Empty space myopia is a phenomenon that has been observed in pilots when flying in the open sky. Previous research has been conducted to develop training biofeedback devices to help pilot visual accommodation in empty skies. During future long-duration spaceflight, astronauts may also experience empty space myopia due to prolonged periods of time i...

Purpose Investigation of pigment epithelial detachment (PED) characteristics in central serous chorioretinopathy (CSCR) is underrepresented in the literature. We present a novel computational approach to quantify PED composition indices (PEDCI) in CSCR and track changes over time. Methods 34 eyes with active CSCR were analyzed quarterly over a 1-y...