Ten-Year Follow-up of a Blind Patient Chronically Implanted with Epiretinal Prosthesis Argus I.

PURPOSE The Argus I implant is the first-generation epiretinal prosthesis approved for an investigational clinical trial by the United States Food and Drug Administration. Herein we report testing results obtained from a 10-year follow-up to study the physiologic effects of the bioelectronic visual implant after prolonged chronic electrical stimulation. DESIGN Case report. PARTICIPANT One man, 55 years of age when enrolled in the study, underwent surgical implantation of the Argus I in June 2004, followed by periodic tests from July 2004 through June 2014, spanning a total of 10 years. METHODS The decade-long follow-up consisted of implant system performance tests, subject visual function evaluation, and implant-retina interface analysis. MAIN OUTCOME MEASURES Changes in electrode impedance and perceptual threshold over the time course; subject's performance on visual function task, orientation, and mobility tests; and optical coherence tomography data, fundus imaging, and fluorescein angiography results for the assessment of subject's implant-retina physical interface. RESULTS Electrically elicited phosphenes were present 10 years after implantation of an epiretinal stimulator. The test subject not only was able to perceive phosphenes, but also could perform visual tasks at rates well above chance. CONCLUSIONS This decade-long follow-up report provides further support for the use of retinal prostheses as a long-lasting treatment for some types of blindness.

[1]  H. Flynn,et al.  Lack of toxicity of stainless steel retinal tacks during 21 years of follow-up. , 2009, Ophthalmic surgery, lasers & imaging : the official journal of the International Society for Imaging in the Eye.

[2]  A. Milam,et al.  Preservation of the inner retina in retinitis pigmentosa. A morphometric analysis. , 1997, Archives of ophthalmology.

[3]  Osamu Sawada,et al.  Comparison of macular thickness between Cirrus HD-OCT and Stratus OCT. , 2008, Ophthalmic surgery, lasers & imaging : the official journal of the International Society for Imaging in the Eye.

[4]  R. H. Propst,et al.  Visual perception elicited by electrical stimulation of retina in blind humans. , 1996, Archives of ophthalmology.

[5]  J. Weiland,et al.  Visual performance using a retinal prosthesis in three subjects with retinitis pigmentosa. , 2007, American journal of ophthalmology.

[6]  Jessy D. Dorn,et al.  Interim results from the international trial of Second Sight's visual prosthesis. , 2012, Ophthalmology.

[7]  Mark S Humayun,et al.  Frequency and amplitude modulation have different effects on the percepts elicited by retinal stimulation. , 2012, Investigative ophthalmology & visual science.

[8]  J. Robson,et al.  Discrimination at threshold: Labelled detectors in human vision , 1981, Vision Research.

[9]  E. Chichilnisky,et al.  Electrical stimulation of mammalian retinal ganglion cells with multielectrode arrays. , 2006, Journal of neurophysiology.

[10]  A. Milam,et al.  Morphometric analysis of the extramacular retina from postmortem eyes with retinitis pigmentosa. , 1999, Investigative ophthalmology & visual science.

[11]  J. L. Stone,et al.  Morphometric analysis of macular photoreceptors and ganglion cells in retinas with retinitis pigmentosa. , 1992, Archives of ophthalmology.

[12]  Mark S Humayun,et al.  Predicting visual sensitivity in retinal prosthesis patients. , 2009, Investigative ophthalmology & visual science.

[13]  M. Humayun,et al.  MORPHOMETRIC ANALYSIS OF THE MACULA IN EYES WITH GEOGRAPHIC ATROPHY DUE TO AGE-RELATED MACULAR DEGENERATION , 2002, Retina.

[14]  Gislin Dagnelie,et al.  Visual perception in a blind subject with a chronic microelectronic retinal prosthesis , 2003, Vision Research.

[15]  R. Jensen,et al.  Thresholds for activation of rabbit retinal ganglion cells with relatively large, extracellular microelectrodes. , 2005, Investigative ophthalmology & visual science.

[16]  Arup Roy,et al.  Factors affecting perceptual thresholds in epiretinal prostheses. , 2008, Investigative ophthalmology & visual science.

[17]  Robert J. Greenberg,et al.  The Argus® II retinal prosthesis system: An overview , 2013, 2013 IEEE International Conference on Multimedia and Expo Workshops (ICMEW).

[18]  J. Weiland,et al.  Retinal prosthesis for the blind. , 2002, Survey of ophthalmology.

[19]  Eyal Margalit,et al.  Retinal and optic nerve diseases. , 2003, Artificial organs.

[20]  J. Weiland,et al.  Perceptual thresholds and electrode impedance in three retinal prosthesis subjects , 2005, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[21]  J. Lim,et al.  Iatrogenic choroidal neovascularization. , 1999, Survey of ophthalmology.

[22]  Jessy D. Dorn,et al.  Blind subjects implanted with the Argus II retinal prosthesis are able to improve performance in a spatial-motor task , 2010, British Journal of Ophthalmology.

[23]  R. Murphy,et al.  Choroidal neovascularization after laser photocoagulation for diabetic macular edema. , 1990, Ophthalmology.

[24]  J. Newman Resistance for Flow of Current to a Disk , 1966 .