Highest reported visual acuity after electronic retinal implantation

Jasmina Cehajic Kapetanovic, Nicole Troelenberg, Thomas L Edwards, Kanmin Xue, James D Ramsden, Alfred Stett, Eberhart Zrenner, Robert E MacLaren, Jasmina Cehajic Kapetanovic, Nicole Troelenberg, Thomas L Edwards, Kanmin Xue, James D Ramsden, Alfred Stett, Eberhart Zrenner, Robert E MacLaren

Abstract

Purpose: To report the highest attained visual acuity with an electronic retinal implant for the treatment of advanced retinal degeneration following a novel intensive period of visual training.

Methods: A case study as part of the prospective, international, multi-centre, interventional clinical trial (ClinicalTrials.gov NCT02720640 and NCT01024803) of patients with the Retina Implant Alpha AMS (Retina Implant AG, Reutlingen, Germany) for advanced retinal degeneration. A patient with subretinal device implanted into worse-seeing eye with no useful perception of light vision secondary to USH2A retinal degeneration underwent intensive period of visual training.

Results: The device remains functional with no safety concerns at 3 years postsurgical implantation, and following visual training, the patient achieved the highest visual acuity so far with an electronic retinal device, with real, digitally unenhanced, reading vision of 0.04 decimal (equivalent to 1.39 LogMAR and 20/500 or 6/150 Snellen). In addition, perception as well as partial identification of obstacles and evaluation of distances was possible in both daylight and night-time settings.

Conclusions: Retinal implants are currently the only available therapy option for advanced retinal degeneration. Visual rehabilitation postimplantation has potential to maximize visual percepts. The novel concept of intensive visual training presented herein shows what is achievable with electronic retinal implants and has implications for other therapeutic options, such as optogenetics, that aim to stimulate remaining inner retinal cells in advanced retinal degeneration.

Keywords: electronic prosthesis; inherited retinal degeneration; retinal implant; visual rehabilitation.

© 2020 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

References

    1. Cehajic-Kapetanovic J, Eleftheriou C, Allen AE et al. (2015): Restoration of vision with ectopic expression of human rod opsin. Current Biol 25: 1-12.
    1. da Cruz L, Dorn JD & Humayun MS et al. (2016): Five-year safety and performance results from the Argus II Retinal Prosthesis System Clinical Trial. Ophthalmology 123: 2248-2254.
    1. Daschner R, Rothermel A, Rudorf R, Rudorf S & Stett A (2018): Functionality and performance of the subretinal implant chip Alpha AMS. Sensors Mat 1484: 179-92.
    1. Edwards TL, Cottriall CL, Xue K, Simunovic MP, Ramsden JD, Zrenner E & MacLaren RE (2018): Assessment of the electronic retinal implant alpha AMS in restoring vision to blind patients with end-stage retinitis pigmentosa. Ophthalmology 125: 432-443.
    1. Gekeler K, Bartz-Schmidt KU, Sachs H, MacLaren RE, Stingl K, Zrenner E & Gekeler F (2018): Implantation, removal and replacement of subretinal electronic implants for restoration of vision in patients with retinitis pigmentosa. Curr Opin Ophthalmol 29: 239-247.
    1. Humayun MS, Dorn JD & da Cruz L et al. (2012): Interim results from the international trial of Second Sight's visual prosthesis. Ophthalmology 119: 779-788.
    1. Liew G, Michaelides M & Bunce C (2014): A comparison of the causes of blindness certifications in England and Wales in working age adults (16-64 years), 1999-2000 with 2009-2010. BMJ Open 4: e004015.
    1. Stingl K, Bartz-Schmidt KU, Besch D et al. (2015): Subretinal visual implant alpha IMS-clinical trial interim report. Vision Res 111(Pt B): 149-60.
    1. Stingl K, Schippert R, Bartz-Schmidt KU et al. (2017): Interim results of a multicenter trial with the new electronic subretinal implant alpha AMS in 15 patients blind from inherited retinal degenerations. Front Neurosci 11: 445.

Source: PubMed

3
구독하다