Abstract

A light-sensitive, externally powered microchip was surgically implanted subretinally near the macular region of volunteers blind from hereditary retinal dystrophy. The implant contains an array of 1500 active microphotodiodes (‘chip’), each with its own amplifier and local stimulation electrode. At the implant's tip, another array of 16 wire-connected electrodes allows light-independent direct stimulation and testing of the neuron–electrode interface. Visual scenes are projected naturally through the eye's lens onto the chip under the transparent retina. The chip generates a corresponding pattern of 38 × 40 pixels, each releasing light-intensity-dependent electric stimulation pulses. Subsequently, three previously blind persons could locate bright objects on a dark table, two of whom could discern grating patterns. One of these patients was able to correctly describe and name objects like a fork or knife on a table, geometric patterns, different kinds of fruit and discern shades of grey with only 15 per cent contrast. Without a training period, the regained visual functions enabled him to localize and approach persons in a room freely and to read large letters as complete words after several years of blindness. These results demonstrate for the first time that subretinal micro-electrode arrays with 1500 photodiodes can create detailed meaningful visual perception in previously blind individuals.

Highlights

  • Retinitis pigmentosa (RP) and age-related macular degeneration are diseases that predominantly affect photoreceptors of the retina and cause progressive vision loss—leading eventually to blindness in over 15 million people worldwide [1]

  • The regained visual functions enabled him to localize and approach persons in a room freely and to read large letters as complete words after several years of blindness. These results demonstrate for the first time that subretinal micro-electrode arrays with 1500 photodiodes can create detailed meaningful visual perception in previously blind individuals

  • This study demonstrated that subretinal micro-electrode arrays can restore visual percepts in patients blind from hereditary retinal degenerations to such an extent that localization and recognition of objects can provide useful vision, up to reading letters

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Summary

INTRODUCTION

Retinitis pigmentosa (RP) and age-related macular degeneration are diseases that predominantly affect photoreceptors of the retina and cause progressive vision loss—leading eventually to blindness in over 15 million people worldwide [1]. Two fundamentally different approaches have been taken in this area: (i) implantation of electrode arrays which interface epiretinally with retinal ganglion cells that form the retinal output pathway [6– 7,11 – 13], and (ii) implantation of microchips under the transparent retina to substitute the degenerated photoreceptors The latter type of microchip senses light and generates stimulation signals simultaneously at many pixel locations, using microphotodiode arrays (MPDAs; [3,14]). This report describes the results of a clinical pilot study, illustrating that subretinally implanted multi-electrode arrays restore sufficient visual function for object recognition and localization and for the performance of visual tasks essential in the daily lives of blind patients. The results of this pilot study provide strong evidence that the visual functions of patients blinded by a hereditary retinal dystrophy can, in principle, be restored to a degree sufficient for use in daily life

THE SUBRETINAL IMPLANT
Findings
CONCLUSION
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