Restoration of Sight with Photovoltaic Retinal Prosthesis

Abstract:

Retinal degenerative diseases, such as Retinitis Pigmentosa (RP) and Age related Macular Degeneration (AMD), lead to loss of sight due to degeneration of photoreceptors, yet the inner retinal neurons which process the visual signals and relay them to the brain are relatively well preserved. Patterned electrical stimulation of the inner retinal neurons can elicit patterned visual perception, thereby restoring sight to some degree, as was demonstrated in recent clinical trials. However, current RF-powered implants require bulky electronics and trans-scleral cables, making implantation very complex and prone to failures. Even more importantly, low visual acuity achieved with the current implants limits their applicability to very small fraction of patients.

We have developed a wireless photovoltaic retinal prosthesis, in which camera-captured images are projected onto the retina using pulsed near-IR light. Each pixel in the subretinal implant directly converts pulsed light into local electric current to stimulate the nearby inner retinal neurons. Implants with pixel sizes of 280, 140 and 70µm were successfully implanted in the subretinal space of wild type and degenerate rats, and elicited robust cortical responses (eVEP) upon stimulation with NIR light. Amplitude of the eVEP increased with peak irradiance and pulse duration, and decreased with frequency in the range of 2-20Hz, similar to the visible light response.

Modular design of the arrays allows scalability to a large number of pixels, and combined with the ease of implantation, offers a promising approach to restoration of sight in patients blinded by retinal degenerative diseases.

Activation of the retinal bipolar cells by the implant makes our model a unique tool for studying retinal circuitry by comparing the response to stimuli elicited by the subretinal implant to those naturally elicited by visible light. I will discuss our novel approach to quantitative assessment of the visual acuity provided by the implant, as well as some unique aspects of prosthetic vision, such as stroboscopic stimulation. The theoretical and practical limits of visual acuity will be discussed along with future directions for restoration of sight to the blind.

I will also discuss another example for application of electric field on cells – namely, irreversible electroporation, a novel approach for non-thermal cell ablation. We have recently reported that short pulses of high electric field can cause tumor ablation in uveal melanoma, the most common intraocular malignancy in adults.