Artificial vision by direct optic nerve electrode (AV-DONE) implantation in a blind patient with retinitis pigmentosa

Abstract

The purpose of this study was to evaluate the efficacy and safety of artificial vision by using a direct optic nerve electrode (AV-DONE) in a blind patient with retinitis pigmentosa (RP). This device, comprising three wire electrodes (0.05 mm in diameter), was implanted into the optic disc of a patient with RP with no light perception vision and the device was left implanted. Six months later, visual sensations were elicited by electrical stimulation through each electrode and the thresholds for the phosphene perception elicited by pulses of 0.25-ms duration/phase and a pulse frequency of 320 Hz were 30, 5, and 70 microA for each electrode. The phosphenes, which ranged in size from that of a match head to an apple, were round, oval, or linear, primarily yellow, and focally distributed. The area of the phosphenes changed when the electrical stimulation was supplied from different electrodes. No complications arose during the follow-up period. Localized visual sensations were produced in a blind patient with advanced RP, suggesting that our system could lead to the development of a useful visual prosthesis system.

Bionic Eyes: Vision Restoration Through Electronic or Photovoltaic Stimulation

“…The alternative penetrating electrodes have had less functional vision success. Whilst it has been shown that intra-orbital optic nerve stimulation with penetrating electrodes can evoke cortical responses in rabbits [ 87 ] and can generate perception of phosphenes in humans [ 84 ], patients implanted with these devices have not been able to use these phosphenes to improve their functional vision and were unable to detect or localise objects with the device.…”

The bionic eye: a review

“…These subjects were able to recognize simple patterns projected onto a screen, 26 localize and discriminate objects 55,59–61 . An alternative to the cuff‐electrode is the insertion of multiple penetrating electrodes onto the optic nerve and optic disc 62–68 . Stimulation of these electrodes in the acute setting have produced the sensation of phosphenes 66 …”

“…An alternative to the cuff‐electrode is the insertion of multiple penetrating electrodes onto the optic nerve and optic disc 62–68 . Stimulation of these electrodes in the acute setting have produced the sensation of phosphenes 66 …”

“…55,[59][60][61] An alternative to the cuff-electrode is the insertion of multiple penetrating electrodes onto the optic nerve and optic disc. [62][63][64][65][66][67][68] Stimulation of these electrodes in the acute setting have produced the sensation of phosphenes. 66 The lateral geniculate nucleus is attractive stimulation target for a visual prosthesis as it is physically adjacent to areas targeted for deep brain stimulation therapy for movement disorders such as Parkinson's disease and hence surgical access will only require minor modification of these techniques.…”

Efficacy of Suprachoroidal–Transretinal Stimulation in a Rabbit Model of Retinal Degeneration

“…Because some of the inner retinal neurons are somewhat preserved in RP patients, 1,2 several research groups are investigating whether an intraocular retinal prosthesis can restore vision in these patients by activating the functioning neurons. [3][4][5][6][7] We have developed a new method of stimulating the retina called suprachoroidal-transretinal stimulation (STS), 8 and experiments on normal rabbits 9,10 and RCS rats 11 have shown that electrically evoked potentials (EEPs) can be elicited by stimulating the retina by STS. However, a middle-sized animal model with damage predominantly in the outer retinal layer, as is observed in eyes of RP patients, is needed to evaluate the effectiveness of the STS system more completely.…”