Development of an Epiretinal Electronic Visual Prosthesis
Diseases of the retina and optic nerve are common causes of irreversible blind- ness. Given the lack of effective treatments, several laboratories are utilizing micro- electronic technology to develop either a cortical or retinal prosthesis. Each strategy offers certain advantages, but both face numerous and formidable challenges. Conse- quently, a clinically useful device of either type is still conceptual. The technological means to build prostheses are available but the ultimate obstacle is the integration of the technology with the brain. This review primarily focuses on our efforts to develop a retinal prosthesis. In particular we address the two problems that we believe to be most challenging: 1) need to demonstrate that retinal stimulation can produce “useful” vision in a blind patient, and 2) need to demonstrate long-term biocomopatibility of an implanted device in an animal.
Brindley produced crude visual sensations by stimulating the visual cortex in a blind patient 32 years ago.1 This early success coupled with the broad therapeutic poten- tial of a cortical prosthesis to treat blindness caused by damage of either the retina or optic nerve has made this pursuit attractive to many scientists. Developing a cortical prosthesis that remains functional and biocompatible for prolonged periods of time is a difficult task and progress has not surprisingly been slow.2 The convoluted surface of the mobile brain and the need for penetration of the subsurface layer of the visual cortex increase the difficulty of maintaining a stable interface. The potential risks of neurosurgery are also a formidable if not simply a psychological barrier for patients.
KeywordsGanglion Cell Retinitis Pigmentosa Cortical Response Retinal Surface Retinal Prosthesis
Unable to display preview. Download preview PDF.
- 1.Brindley G and Lewin W. The sensations produced by electrical stimulation of the visual cortex. J. Physiol (Lond). 1968;196:479–493.Google Scholar