Transorbital electrical stimulation in retinitis pigmentosa. Better results joining visual pattern stimulation?

Rossi, Francesca; Guidobaldi, Margherita; Turco, Simona; Amore, Filippo

doi:10.1016/j.brs.2020.05.014

Cited by 6 publications

(4 citation statements)

References 10 publications

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“…Previous clinical studies have evaluated the effect of electrical stimulation on RP [58][59][60]. These studies have made use of a range of electrical stimulation settings, as well as several stimulation sites including transcorneal, transdermal and transorbital electrical stimulation but with limited improvement of vision [58][59][60]. This probably related to poor spatial resolution of electrical stimuli, the site of stimulation and the late timing of intervention.…”

Section: Discussionmentioning

confidence: 99%

Ocular Neuromodulation as a Novel Treatment for Retinitis Pigmentosa: Identifying Rod Responders and Predictors of Visual Improvement

Musallam

2023

Preprint

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Starvation of photoreceptors induced by reduced dysregulated ocular blood flow (OBF) is proposed as a common pathway for pathogenesis of retinitis pigmentosa (RP). The current study evaluated the safety and efficacy of ophthalmic nerve stimulation (ONS) as an OBF neuromodulator, combined with ascorbic acid (AA) as a potent anti-oxidant in treatment of RP. Additionally, the initial characteristics of rod responders were identified. Forty participants with simple RP, were enrolled in a prospective open-label intervention. The severity of the disease was clinically graded into five stages. Patients with established diagnosis of RP; aged ≥ 4 years, with BCVA ≥ 20/400 were included. All participants were daily treated with bilateral ONS sessions combined with systemic AA for two weeks. The primary efficiency endpoint was 6 months’ changes in scotopic vision as measured by a 10-items, 100 points, Low Luminance Questionnaire- (LLQ-10). The secondary efficiency points included best corrected visual acuity (BCVA) and contrast sensitivity (CS). Rod responders were defined by ≥ 25points increment of LLQ-10 score. The results showed that ONS combined with AA treatment significantly improved night vision, BCVA and CS in patients with RP. At 6-month visit, twenty-four (60%) patients were identified as rod responders and 16 (40%) patients were non-responders. The mean change in LLQ-10 score was (46.35 ±16.81) in rod responders versus (4.9 ± 7.6) in non-responders (P < 0.0001). A clinically significant improvement of BCVA (≥0.2 logMAR) and CS (≥0.3 log unit) were demonstrated in 44.4% and 56.1% of eyes of rod responders respectively. Collectively, this study sheds light on determinants of rod responsiveness which include patients’ age, duration of night blindness and the stage of RP. It also highlights two therapeutic scenarios; an early disease -modifying intervention that restore night vision and reverse the disease process and a late cone rescue intervention that improve/maintain central vision.

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Section: Discussionmentioning

confidence: 99%

Ocular Neuromodulation as a Novel Treatment for Retinitis Pigmentosa: Identifying Rod Responders and Predictors of Visual Improvement

Musallam

2023

Preprint

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“…More recently, an increased beneficial effect of rtACS has been observed when used in combination with visual stimulation (de Rossi et al, 2020). Patients with RP were divided into 2 groups.…”

Section: Repetitive Transorbital Alternating Currentmentioning

confidence: 99%

Vision recovery with perceptual learning and non-invasive brain stimulation: Experimental set-ups and recent results, a review of the literature

Battaglini

Ponzio

Ghiani

et al. 2022

RNN

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Background: Vision is the sense which we rely on the most to interact with the environment and its integrity is fundamental for the quality of our life. However, around the globe, more than 1 billion people are affected by debilitating vision deficits. Therefore, finding a way to treat (or mitigate) them successfully is necessary. Objective: This narrative review aims to examine options for innovative treatment of visual disorders (retinitis pigmentosa, macular degeneration, optic neuropathy, refractory disorders, hemianopia, amblyopia), especially with Perceptual Learning (PL) and Electrical Stimulation (ES). Methods: ES and PL can enhance visual abilities in clinical populations, inducing plastic changes. We describe the experimental set-up and discuss the results of studies using ES or PL or their combination in order to suggest, based on literature, which treatment is the best option for each clinical condition. Results: Positive results were obtained using ES and PL to enhance visual functions, for example, repetitive transorbital Alternating Current Stimulation (rtACS) appeared as the most effective treatment for pre-chiasmatic disorders such as optic neuropathy. A combination of transcranial Direct Current Stimulation (tDCS) and visual training seems helpful for people with hemianopia, while transcranial Random Noise Stimulation (tRNS) makes visual training more efficient in people with amblyopia and mild myopia. Conclusions: This narrative review highlights the effect of different ES montages and PL in the treatment of visual disorders. Furthermore, new options for treatment are suggested. It is noteworthy to mention that, in some cases, unclear results emerged and others need to be more deeply investigated.

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“…максимум [28]. В результате ЭОС при пигментной абиотрофии сетчатки наблюдали улучшение периферического поля зрения и вариабельное повышение параметров светочувствительности сетчатки по данным компьютерной периметрии [28,29].…”

Section: клиническая эффективность электроофтальмостимуляцииunclassified

The Role of Electrical Stimulation in Management of Retinal and Optic Nerve Degenerative and Dystrophic Disorders. Literature Review

Pateyuk¹,

Drakon²,

Sheludchenko³

et al. 2021

Oftalʹmologiâ

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This article presents actual data on the retinal and optic nerve electrical stimulation. The physical basics of the electrical stimulation biological effect on cellular elements and nerve fibers are discussed. Ocular indications for electrical stimulation, as well as local and general contraindications are listed. Strategies of delivery and brief historical overview are given. The article presents current data on the electrical stimulation clinical effectiveness in the management of patients with degenerative and dystrophic diseases of the retina and optic nerve: age-related macular degeneration, retinitis pigmentosa, optic nerve atrophy and glaucoma optic neuropathy. The data on the clinical efficacy of electrophthalmostimulation in the treatment of patients with degenerative-dystrophic diseases of the retina and optic nerve: age-related macular degeneration, retinal pigment abiotrophy, optic nerve atrophy and glaucoma optic neuropathy are presented. Electrophthalmostimulation is a modern method of physical treatment of patients with diseases of the retina and optic nerve of a degenerative-dystrophic nature. The method is generally recognized and widely used in clinical work, not only traditionally on the territory of the Russian Federation, but also in world practice. In experiments and on animal models, the indisputable advantage of electrical stimulation of the retina and optic nerve has been proven — the etiopathogenetically determined preservation of the remaining and restoration of lost visual functions in case of ophthalmic diseases leading to blindness. Further development of this direction of electrotherapy includes standardization of the most effective techniques for various ophthalmopathologies and optimization of the parameters of courses and sessions of electrical stimulation of the retina and optic nerve. The latter presupposes the conduct of multicenter, randomized, placebo-controlled clinical trials with a sufficient volume of clinical material and reliable statistical processing of the results obtained.

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Transorbital electrical stimulation in retinitis pigmentosa. Better results joining visual pattern stimulation?

Cited by 6 publications

References 10 publications

Ocular Neuromodulation as a Novel Treatment for Retinitis Pigmentosa: Identifying Rod Responders and Predictors of Visual Improvement

Ocular Neuromodulation as a Novel Treatment for Retinitis Pigmentosa: Identifying Rod Responders and Predictors of Visual Improvement

Vision recovery with perceptual learning and non-invasive brain stimulation: Experimental set-ups and recent results, a review of the literature

The Role of Electrical Stimulation in Management of Retinal and Optic Nerve Degenerative and Dystrophic Disorders. Literature Review

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