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Ghani N, Bansal J, Naidu A, Chaudhary KM. Long term positional stability of the Argus II retinal prosthesis epiretinal implant. BMC Ophthalmol 2023; 23:70. [PMID: 36797684 PMCID: PMC9933348 DOI: 10.1186/s12886-022-02736-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 12/13/2022] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND The Argus II Retinal Prosthesis System (Second Sight Medical Products, Sylmar, California) is an epiretinal prosthesis that serves to provide useful vision to people who are affected by retinal degenerative diseases such as retinitis pigmentosa (RP). The purpose of this study was to analyze postoperative movement of the electrode array. METHODS Five patients diagnosed with profound retinal dystrophy who have undergone implantation of retinal prosthesis at Stony Brook University Hospital. Fundoscopy was performed at postoperative month 1 (M1), month 3 (M3), month 6 (M6), month 12 (M12), and month 24 (M24) visits. Fundoscopy was extracted and analyzed via NIH ImageJ. Data analysis was completed using IBM SPSS. Various lengths and angles were measured each postoperative month using ImageJ. RESULTS There was no significant change in distance between the optic disc and the surgical handle (length AB) over the two-year span (F = 0.196, p = 0.705). There was a significant change in distance of length AB over time between patients between M3 and M6 (p = 0.025). A repeated measures ANOVA revealed that there was statistically significant change of the optic disc-tack-surgical handle angle (𝛾) (M1 to M24) (F = 3.527, p = 0.030). There was no significant change in angle 𝜟 (the angle to the horizontal of the image), angle 𝜶 (tack-optic disc-surgical handle), and angle 𝜷 (optic-disc-surgical handle-tack). CONCLUSION Our results demonstrate that there may be postoperative movement of the retinal prosthesis over time, as a statistically significant downward rotation is reported over the 2 years span. It is important, moving forward, to further study this movement and to take into consideration such movement when designing retinal implants. It is important to note that this study is limited by the small sample size, and therefore, the conclusions drawn are limited.
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Affiliation(s)
- Nimra Ghani
- Department of Ophthalmology, Stony Brook University Hospital, Stony Brook, NY, 11790, USA.
| | - Jahnvi Bansal
- grid.412695.d0000 0004 0437 5731Department of Ophthalmology, Stony Brook University Hospital, Stony Brook, NY 11790 USA
| | - Abhishek Naidu
- grid.412695.d0000 0004 0437 5731Department of Ophthalmology, Stony Brook University Hospital, Stony Brook, NY 11790 USA
| | - Khurram M. Chaudhary
- grid.412695.d0000 0004 0437 5731Department of Ophthalmology, Stony Brook University Hospital, Stony Brook, NY 11790 USA
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Haji Ghaffari D, Akwaboah AD, Mirzakhalili E, Weiland JD. Real-Time Optimization of Retinal Ganglion Cell Spatial Activity in Response to Epiretinal Stimulation. IEEE Trans Neural Syst Rehabil Eng 2021; 29:2733-2741. [PMID: 34941514 PMCID: PMC8851408 DOI: 10.1109/tnsre.2021.3138297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Retinal prostheses aim to improve visual perception in patients blinded by photoreceptor degeneration. However, shape and letter perception with these devices is currently limited due to low spatial resolution. Previous research has shown the retinal ganglion cell (RGC) spatial activity and phosphene shapes can vary due to the complexity of retina structure and electrode-retina interactions. Visual percepts elicited by single electrodes differ in size and shapes for different electrodes within the same subject, resulting in interference between phosphenes and an unclear image. Prior work has shown that better patient outcomes correlate with spatially separate phosphenes. In this study we use calcium imaging, in vitro retina, neural networks (NN), and an optimization algorithm to demonstrate a method to iteratively search for optimal stimulation parameters that create focal RGC activation. Our findings indicate that we can converge to stimulation parameters that result in focal RGC activation by sampling less than 1/3 of the parameter space. A similar process implemented clinically can reduce time required for optimizing implant operation and enable personalized fitting of retinal prostheses.
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Kmon P. Highly Configurable 100 Channel Recording and Stimulating Integrated Circuit for Biomedical Experiments. SENSORS (BASEL, SWITZERLAND) 2021; 21:8482. [PMID: 34960575 PMCID: PMC8705452 DOI: 10.3390/s21248482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/13/2021] [Accepted: 12/16/2021] [Indexed: 11/16/2022]
Abstract
This paper presents the design results of a 100-channel integrated circuit dedicated to various biomedical experiments requiring both electrical stimulation and recording ability. The main design motivation was to develop an architecture that would comprise not only the recording and stimulation, but would also block allowing to meet different experimental requirements. Therefore, both the controllability and programmability were prime concerns, as well as the main chip parameters uniformity. The recording stage allows one to set their parameters independently from channel to channel, i.e., the frequency bandwidth can be controlled in the (0.3 Hz-1 kHz)-(20 Hz-3 kHz) (slow signal path) or (0.3 Hz-1 kHz)-4.7 kHz (fast signal path) range, while the voltage gain can be set individually either to 43.5 dB or 52 dB. Importantly, thanks to in-pixel circuitry, main system parameters may be controlled individually allowing to mitigate the circuitry components spread, i.e., lower corner frequency can be tuned in the 54 dB range with approximately 5% precision, and the upper corner frequency spread is only 4.2%, while the voltage gain spread is only 0.62%. The current stimulator may also be controlled in the broad range (69 dB) with its current setting precision being no worse than 2.6%. The recording channels' input-referred noise is equal to 8.5 µVRMS in the 10 Hz-4.7 kHz bandwidth. The single-pixel occupies 0.16 mm2 and consumes 12 µW (recording part) and 22 µW (stimulation blocks).
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Affiliation(s)
- Piotr Kmon
- Department of Measurement and Electronics, AGH University of Science and Technology, Al. Mickiewicza 30, 30-059 Cracow, Poland
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Delyfer M, Gaucher D, Mohand‐Saïd S, Barale P, Rezaigua‐Studer F, Ayello‐Scheer S, Dollfus H, Dorn JD, Korobelnik J, Sahel J. Improved performance and safety from Argus II retinal prosthesis post-approval study in France. Acta Ophthalmol 2021; 99:e1212-e1221. [PMID: 33354943 DOI: 10.1111/aos.14728] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 10/22/2020] [Accepted: 11/29/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate the post-approval long-term outcomes of the Argus II Retinal Prosthesis, with a specific focus on its functional visual benefit in patients' daily activities. METHODS Eighteen patients with bare light perception due to end-stage retinitis pigmentosa were included in a French prospective, multicentre, single-arm study and followed for 2 years. Visual benefit in patients' daily activities was monitored through the use of the Functional Low-vision Observer Rated Assessment (FLORA), and the final score at 2 years was the primary effectiveness outcome. Standardized visual assessments were also performed. Device- or procedure-related adverse events were recorded. RESULTS Seventeen subjects completed the study. Positive impacts of the Argus II system on functional vision and well-being were demonstrated for over 70% of subjects on the FLORA. Among the daily activities/tasks tested, finding doorways was one of the most statistically significantly improved tasks (p < 0.001), along with estimating the size of an obstacle (p < 0.001), visually locating a place setting on a dining table (p < 0.001) and visually locating people in a non-crowded setting (p < 0.001). Visual function was improved on most standardized tests. Only two device- or procedure-related serious adverse events were observed (one vitreous haemorrhage and one endophthalmitis, both resolved with treatment). No explantation was required. CONCLUSION This first report of a completed post-approval study of Argus II with a two-year follow-up demonstrates the safety and effectiveness of the Argus II System in a real-world cohort of patients and further highlights its real functional benefit in implanted patients' daily activities.
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Affiliation(s)
- Marie‐Noëlle Delyfer
- Inserm Bordeaux Population Health Research Center Team LEHA UMR1219 Univ. Bordeaux Bordeaux France
- Department of Ophthalmology Bordeaux University Hospital Bordeaux France
| | - David Gaucher
- Department of Ophthalmology NHC University Hospital of Strasbourg Strasbourg France
- EA‐7290 Institut de Bactériologie Fédération de Médecine Translationnelle de Strasbourg Université de Strasbourg Strasbourg France
| | - Saddek Mohand‐Saïd
- CHNO des Quinze‐Vingts DHU Sight Restore INSERM‐DGOS CIC 1423 Paris France
- UPMC Univ Paris 06 INSERM U968 CNRS UMR 7210 Institut de la Vision Sorbonne Universités Paris France
| | | | - Fouzia Rezaigua‐Studer
- Centre de Référence Pour les Affections Rares en Génétique Ophtalmologique, CARGO Filière SENSGENE Hôpitaux Universitaires de Strasbourg Strasbourg France
| | | | - Hélène Dollfus
- Centre de Référence Pour les Affections Rares en Génétique Ophtalmologique, CARGO Filière SENSGENE Hôpitaux Universitaires de Strasbourg Strasbourg France
- Medical Genetics Laboratory INSERM U1112 Institute of Medical Genetics of Alsace Strasbourg Medical School University of Strasbourg Strasbourg France
| | | | - Jean‐François Korobelnik
- Inserm Bordeaux Population Health Research Center Team LEHA UMR1219 Univ. Bordeaux Bordeaux France
- Department of Ophthalmology Bordeaux University Hospital Bordeaux France
| | - José‐Alain Sahel
- CHNO des Quinze‐Vingts DHU Sight Restore INSERM‐DGOS CIC 1423 Paris France
- UPMC Univ Paris 06 INSERM U968 CNRS UMR 7210 Institut de la Vision Sorbonne Universités Paris France
- Fondation Ophtalmologique Rothschild Paris France
- Department of Ophthalmology University of Pittsburgh School of Medicine Pittsburgh PA USA
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Tang N, Fan J, Wang P, Shi G. Microscope integrated optical coherence tomography system combined with augmented reality. OPTICS EXPRESS 2021; 29:9407-9418. [PMID: 33820369 DOI: 10.1364/oe.420375] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/03/2021] [Indexed: 06/12/2023]
Abstract
One of the disadvantages in microscope-integrated optical coherence tomography (MI-OCT) systems is that medical images acquired via different modalities are usually displayed independently. Hence, surgeons have to match two-dimensional and three-dimensional images of the same operative region subjectively. In this paper, we propose a simple registration method to overcome this problem by using guided laser points. This method combines augmented reality with an existing MI-OCT system. The basis of our idea is to introduce a guiding laser into the system, which allows us to identify fiducials in microscopic images. At first, the applied voltages of the scanning galvanometer mirror are used to calculate the fiducials' coordinates in an OCT model. After gathering data at the corresponding points' coordinates, the homography matrix and camera parameters are used to superimpose a reconstructed model on microscopic images. After performing experiments with artificial and animal eyes, we successfully obtain two-dimensional microscopic images of scanning regions with depth information. Moreover, the registration error is 0.04 mm, which is within the limits of medical and surgical errors. Our proposed method could have many potential applications in ophthalmic procedures.
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Yoon YH, Humayun MS, Kim YJ. One-Year Anatomical and Functional Outcomes of the Argus II Implantation in Korean Patients with Late-Stage Retinitis Pigmentosa: A Prospective Case Series Study. Ophthalmologica 2020; 244:291-300. [PMID: 33279905 DOI: 10.1159/000513585] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 12/03/2020] [Indexed: 12/28/2022]
Abstract
PURPOSE To report the anatomical and functional outcomes of Argus II retinal prosthesis implantation in Korean patients. METHODS We included 5 consecutive patients with end-stage retinitis pigmentosa (RP) who underwent Argus II retinal prosthesis implantation and were followed for at least 12 months. The transcorneal electrical evoked response was utilized for patient selection. We used intraoperative optical coherence tomography (OCT) for optimal placement of the array and provided specialized vision rehabilitation training. A morphological evaluation using SD-OCT and a functional evaluation using computer-based visual function tests, a letter-reading ability test, and the Functional Low-Vision Observer Rated Assessment (FLORA) were conducted. RESULTS Postoperatively, the array was completely apposed to the retinal surface in all eyes, except for one eye which had a preexisting macular concavity. Fibrosis-like tissues of ≥50-μm thickness developed at the interface in 2 eyes. All of the patients showed improvement in computer-based visual function tests and could read ETDRS letters at a distance of 50 cm. Three patients could read Korean words. FLORA was improved in all patients, mainly in tasks of visual mobility, daily activities, and social interactions. CONCLUSIONS Along with good anatomical outcomes and specialized rehabilitation practices, recipients of the Argus II implant showed profound improvements in functional vision and mobility.
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Affiliation(s)
- Young Hee Yoon
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea,
| | - Mark S Humayun
- USC Roski Eye Institute, USC Ginsburg Institute for Biomedical Therapeutics, University of Southern California, Los Angeles, California, USA
| | - Yoon Jeon Kim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Naidu A, Ghani N, Yazdanie MS, Chaudhary K. Effect of the electrode array-retina gap distance on visual function in patients with the Argus II retinal prosthesis. BMC Ophthalmol 2020; 20:366. [PMID: 32943044 PMCID: PMC7495685 DOI: 10.1186/s12886-020-01631-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 08/31/2020] [Indexed: 11/10/2022] Open
Abstract
Background Post-implantation visual outcomes in patients with the Argus II Retinal Prosthesis is dependent on a multitude of factors including the positioning of the electrode array on the retina. The purpose of this study is to determine whether the average electrode array-retina gap distance correlates with objective visual function outcomes and sensitivity detection thresholds in patients implanted with the Argus II Retinal Prosthesis. Methods Five patients with implantation of the Argus II Retinal Prosthesis were enrolled in this single-institution retrospective study. Patient demographics were collected from medical records. Visual function data (Square Localization [SL] and Direction of Motion [DOM]) and Optical Coherence Tomography (Cirrus HD-OCT) images were extracted retrospectively from the Argus II Retinal Prosthesis Post-Approval study. Visual function tests were performed with the device OFF and ON at each study visit. Electrode array-retina gap distances were measured at each of the array’s 60 electrodes using the Cirrus HD-OCT software in both the nasotemporal and superoinferior planes. Data was obtained at baseline, and post-operative month 1, month 3, month 6, and year 1. Sensitivity detection thresholds were obtained at the initial programming visit and each reprogramming session. Results Three patients performed significantly better in SL visual function testing with the device ON. Patients that worsened in visual function testing with the device ON in both SL and DOM testing had a statistically significant decrease in performance. The electrode array-retina gap distance was found to effect performance in SL testing in a patient-dependent manner. No effect was found between the electrode-array gap distance and DOM testing or sensitivity detection threshold. Conclusion Our results demonstrate that the electrode array-retina gap distance may affect visual function outcomes in SL testing in certain patients with the Argus II Retinal Prosthesis, and the direction and magnitude of this effect is likely patient-dependent. Furthermore, complete apposition between the electrode array and retina may not always be necessary to achieve optimal visual outcomes.
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Affiliation(s)
- Abhishek Naidu
- Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, 11794, USA.
| | - Nimra Ghani
- Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, 11794, USA
| | | | - Khurram Chaudhary
- Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, 11794, USA
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Lemoine D, Simon E, Buc G, Deterre M. In vitro reliability testing and in vivo lifespan estimation of wireless Pixium Vision PRIMA photovoltaic subretinal prostheses suggest prolonged durability and functionality in clinical practice. J Neural Eng 2020; 17:035005. [PMID: 32357356 DOI: 10.1088/1741-2552/ab8f70] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Retinal implants have the potential to restore some sight in patients with retinal degeneration. The PRIMA implant's novel design features simpler insertion and no transscleral cabling or extraocular components. This in vitro study investigated PRIMA's durability under real time and accelerated conditions and estimated the device's lifespan in vivo. APPROACH Two potential failure modes were examined: corrosion and overstimulation. Real-time aging was tested using implants immersed in balanced saline solution (BSS) at 37 °C, mimicking the intraocular environment. Accelerated aging was examined at 77 °C (Arrhenius theory). Confirmatory testing of acceleration factor was performed using different temperatures (37 °C-87 °C) and weakened implant coatings. The effect of repeated maximum stimulation was tested using a pulsed infrared laser (6x acceleration factor). Data were used to estimate device lifespan. MAIN RESULTS 175 implants were tested for up to 33 months. No corrosion or water ingress was observed after approximately 20 accelerated years. A pixel failure rate of 0.15% was recorded after 10 accelerated years' stimulation. The derived lifespan estimation for the PRIMA implant was 27.0 years with a reliability of 90% (95% confidence interval). SIGNIFICANCE The PRIMA implant was found to be robust, with in vitro reliability of at least 10 years. The PRIMA implant shows durability and functionality for clinically relevant timespans under similar environmental conditions to the human eye. These results require in vivo confirmation.
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Im M, Kim SW. Neurophysiological and medical considerations for better-performing microelectronic retinal prostheses. J Neural Eng 2020; 17:033001. [PMID: 32329755 DOI: 10.1088/1741-2552/ab8ca9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Maesoon Im
- Center for BioMicrosystems, Brain Science Institute, Korea Institute of Science and Technology (KIST), Seoul, Republic of Korea. Division of Bio-Medical Science & Technology, KIST School, University of Science and Technology (UST), Seoul, Republic of Korea
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Rizzo S, Barale PO, Ayello-Scheer S, Devenyi RG, Delyfer MN, Korobelnik JF, Rachitskaya A, Yuan A, Jayasundera KT, Zacks DN, Handa JT, Montezuma SR, Koozekanani D, Stanga PE, da Cruz L, Walter P, Augustin AJ, Chizzolini M, Olmos de Koo LC, Ho AC, Kirchhof B, Hahn P, Vajzovic L, Iezzi R, Gaucher D, Arevalo JF, Gregori NZ, Grisanti S, Özmert E, Yoon YH, Kokame GT, Lim JI, Szurman P, de Juan E, Rezende FA, Salzmann J, Richard G, Huang SS, Merlini F, Patel U, Cruz C, Greenberg RJ, Justus S, Cinelli L, Humayun MS. ADVERSE EVENTS OF THE ARGUS II RETINAL PROSTHESIS: Incidence, Causes, and Best Practices for Managing and Preventing Conjunctival Erosion. Retina 2020; 40:303-311. [PMID: 31972801 DOI: 10.1097/iae.0000000000002394] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE To analyze and provide an overview of the incidence, management, and prevention of conjunctival erosion in Argus II clinical trial subjects and postapproval patients. METHODS This retrospective analysis followed the results of 274 patients treated with the Argus II Retinal Prosthesis System between June 2007 and November 2017, including 30 subjects from the US and European clinical trials, and 244 patients in the postapproval phase. Results were gathered for incidence of a serious adverse event, incidence of conjunctival erosion, occurrence sites, rates of erosion, and erosion timing. RESULTS Overall, 60% of subjects in the clinical trial subjects versus 83% of patients in the postapproval phase did not experience device- or surgery-related serious adverse events. In the postapproval phase, conjunctival erosion had an incidence rate of 6.2% over 5 years and 11 months. In 55% of conjunctival erosion cases, erosion occurred in the inferotemporal quadrant, 25% in the superotemporal quadrant, and 20% in both. Sixty percent of the erosion events occurred in the first 15 months after implantation, and 85% within the first 2.5 years. CONCLUSION Reducing occurrence of conjunctival erosion in patients with the Argus II Retinal Prosthesis requires identification and minimization of risk factors before and during implantation. Implementing inverted sutures at the implant tabs, use of graft material at these locations as well as Mersilene rather than nylon sutures, and accurate Tenon's and conjunctiva closure are recommended for consideration in all patients.
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Affiliation(s)
- Stanislao Rizzo
- Azienda Ospedaliera Universitaria Careggi, Department of Medicine and Translational Surgery, University of Florence, Florence, Italy
| | - Pierre-Olivier Barale
- Sorbonne University, UPMC Univ Paris 06, INSERM U968, CNRS UMR 7210, Institute of Vision, Paris, France
- CHNO des Quinze-Vingts, DHU Sight Restore, INSERM-DGOS CIC 1423, Paris, France
| | - Sarah Ayello-Scheer
- CHNO des Quinze-Vingts, DHU Sight Restore, INSERM-DGOS CIC 1423, Paris, France
| | - Robert G Devenyi
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Marie-Noëlle Delyfer
- Inserm, Bordeaux Population Health Research Center, Team LEHA, University of Bordeaux, Bordeaux, France
- Department of Ophthalmology, Bordeaux University Hospital, Bordeaux, France
| | - Jean-François Korobelnik
- Inserm, Bordeaux Population Health Research Center, Team LEHA, University of Bordeaux, Bordeaux, France
- Department of Ophthalmology, Bordeaux University Hospital, Bordeaux, France
| | | | - Alex Yuan
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio
| | | | - David N Zacks
- Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan
| | - James T Handa
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Sandra R Montezuma
- Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota
| | - Dara Koozekanani
- Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota
| | - Paulo E Stanga
- Manchester Vision Regeneration (MVR) Lab, Manchester Royal Eye Hospital, NIHR Manchester Clinical Research Facility and Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - Lyndon da Cruz
- NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital, London, United Kingdom
| | - Peter Walter
- Department of Ophthalmology, RWTH Aachen University, Aachen, Germany
| | - Albert J Augustin
- Department of Ophthalmology, Staedtisches Klinikum Karlsruhe, Karlsruhe, Germany
| | - Marzio Chizzolini
- Unità Operativa Complessa di Oculistica, Camposampiero-Cittadella (Padova), Padua, Italy
| | - Lisa C Olmos de Koo
- Department of Ophthalmology, UW Medicine Eye Institute, University of Washington, Seattle, Washington
| | - Allen C Ho
- The Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Philadelphia, Pennsylvania, Pennsylvania
| | - Bernd Kirchhof
- Department of Retina and Vitreous Surgery, Center of Ophthalmology, University of Cologne, Cologne, Germany
| | - Paul Hahn
- New Jersey Retina, Teaneck, New Jersey
| | - Lejla Vajzovic
- Department of Ophthalmology, Duke University School of Medicine, Durham, North Carolina
| | - Raymond Iezzi
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota, Minnesota
| | - David Gaucher
- Nouvel Hôpital Civil, University Hospitals of Strasbourg, Strasbourg, France
- Laboratory of Bacteriology (EA- 7290), The Federation of Translational Medicine of Strasbourg, University of Strasbourg, Strasbourg, France
| | - J Fernando Arevalo
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ninel Z Gregori
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami
| | - Salvatore Grisanti
- Department of Ophthalmology, University of Luebeck, UKSH Luebeck, Germany
| | - Emin Özmert
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Young Hee Yoon
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | | | - Jennifer I Lim
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois
| | - Peter Szurman
- Knappschaft Eye Clinic Sulzbach, Knappschaft Hospital Saar, Sulzbach/Saar, Germany
| | | | - Flavio A Rezende
- Department of Ophthalmology, Hôpital Maisonneuve-Rosemont, University of Montreal, Montreal, Québec, Canada
| | - Joël Salzmann
- Department of Ophthalmology, Clinique Générale-Beaulieu, Geneva, Switzerland
| | - Gisbert Richard
- Department of Ophthalmology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | | | | | - Uday Patel
- Second Sight Medical Products, Inc, Sylmar, California
| | - Cynthia Cruz
- Second Sight Medical Products, Inc, Sylmar, California
| | | | | | - Laura Cinelli
- Azienda Ospedaliera Universitaria Careggi, Department of Medicine and Translational Surgery, University of Florence, Florence, Italy
| | - Mark S Humayun
- USC Institute for Biomedical Therapeutics, USC Roski Eye Institute, University of Southern California, Los Angeles, California; and
- Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California
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Influence of optic media of the human eye on the imaging of Argus® II retinal prosthesis with intraoperative spectral-domain optical coherence tomography. SPEKTRUM DER AUGENHEILKUNDE 2020. [DOI: 10.1007/s00717-019-0429-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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12
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Rizzo S, Barale PO, Ayello-Scheer S, Devenyi RG, Delyfer MN, Korobelnik JF, Rachitskaya A, Yuan A, Jayasundera KT, Zacks DN, Handa JT, Montezuma SR, Koozekanani D, Stanga P, da Cruz L, Walter P, Augustin AJ, Olmos de Koo LC, Ho AC, Kirchhof B, Hahn P, Vajzovic L, Iezzi R, Gaucher D, Arevalo JF, Gregori NZ, Wiedemann P, Özmert E, Lim JI, Rezende FA, Huang SS, Merlini F, Patel U, Greenberg RJ, Justus S, Bacherini D, Cinelli L, Humayun MS. Hypotony and the Argus II retinal prosthesis: causes, prevention and management. Br J Ophthalmol 2019; 104:518-523. [DOI: 10.1136/bjophthalmol-2019-314135] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 06/23/2019] [Accepted: 06/24/2019] [Indexed: 01/15/2023]
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Rizzo S, Cinelli L, Finocchio L, Tartaro R, Santoro F, Gregori NZ. Assessment of Postoperative Morphologic Retinal Changes by Optical Coherence Tomography in Recipients of an Electronic Retinal Prosthesis Implant. JAMA Ophthalmol 2019; 137:272-278. [PMID: 30605209 PMCID: PMC6439717 DOI: 10.1001/jamaophthalmol.2018.6375] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 11/09/2018] [Indexed: 01/10/2023]
Abstract
Importance The postoperative retinal changes at the interface between an implant electrode array and the retina and whether these anatomic changes have an association with the patient visual performance are unknown. Objective To report morphologic changes in recipients of an Argus II Retinal Prosthesis. Design, Setting, and Participants This consecutive, noncomparative case series study included a retrospective review of the preoperative and postoperative optical coherence tomography of 33 eyes among 33 individuals who underwent Argus II Retinal Prosthesis System implantation between October 28, 2011, and June 8, 2017, at 2 different centers, by the same surgeon (S.R.). Thirteen patients received an implant at Azienda Ospedaliero Universitaria Pisana, Pisa, Italy, between October 28, 2011, and October 27, 2014, and 20 patients underwent surgery at Azienda Ospedaliera Universitaria Careggi, Florence, Italy, between December 20, 2014, and June 8, 2017. Patients were excluded if they did not reach the 6-month follow-up. Main Outcomes and Measures All patients were evaluated before surgery, during the first postoperative day, and at 1, 3, 6, 12, and 24 months (subsequently once a year, except for patient-related adverse events), with a comprehensive ophthalmic examination, retinal fundus photography, spectral-domain optical coherence tomography, and visual function tests to evaluate the stability or improvement of their visual performance. Results Of the 20 patients included in the analysis, all were of white race/ethnicity, 12 (60%) were male, and the mean (SD) age was 57.4 (11.6) years. Optical coherence tomography revealed the development of a fibrosislike hyperreflective tissue limited at the interface between the array and retina in 10 eyes (50%). In 9 of 10 patients (90%), fibrosis evolved and progressed to retinal schisis. Despite the development of the fibrosis and schisis, there was no deterioration in the patient's visual performance evaluated prospectively with visual function tests (square localization and direction of motion). Conclusions and Relevance Optical coherence tomography may be used to observe the retinal anatomic changes in patients with an Argus II Prothesis. This analysis revealed the development of a fibrosislike hyperreflective tissue limited at the interface between array and retina that progressed to retinal schisis but with no deterioration in the patients' visual performance.
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Affiliation(s)
- Stanislao Rizzo
- Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina e Chirurgia Traslazionale, University of Florence, Florence, Italy
| | - Laura Cinelli
- Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina e Chirurgia Traslazionale, University of Florence, Florence, Italy
| | - Lucia Finocchio
- Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina e Chirurgia Traslazionale, University of Florence, Florence, Italy
| | - Ruggero Tartaro
- Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina e Chirurgia Traslazionale, University of Florence, Florence, Italy
| | - Francesca Santoro
- Azienda Ospedaliera Universitaria Careggi, Dipartimento di Medicina e Chirurgia Traslazionale, University of Florence, Florence, Italy
| | - Ninel Z. Gregori
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, Florida
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Haller JA. Optical Coherence Tomography to Assess Anatomic Changes in Recipients of Electronic Retinal Implants. JAMA Ophthalmol 2019; 137:279-280. [DOI: 10.1001/jamaophthalmol.2018.6386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Julia A. Haller
- Wills Eye Hospital, Philadelphia, Pennsylvania
- Department of Ophthalmology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
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Gregori NZ, Callaway NF, Hoeppner C, Yuan A, Rachitskaya A, Feuer W, Ameri H, Arevalo JF, Augustin AJ, Birch DG, Dagnelie G, Grisanti S, Davis JL, Hahn P, Handa JT, Ho AC, Huang SS, Humayun MS, Iezzi R, Jayasundera KT, Kokame GT, Lam BL, Lim JI, Mandava N, Montezuma SR, Olmos de Koo L, Szurman P, Vajzovic L, Wiedemann P, Weiland J, Yan J, Zacks DN. Retinal Anatomy and Electrode Array Position in Retinitis Pigmentosa Patients After Argus II Implantation: An International Study. Am J Ophthalmol 2018; 193:87-99. [PMID: 29940167 DOI: 10.1016/j.ajo.2018.06.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 06/12/2018] [Accepted: 06/13/2018] [Indexed: 01/26/2023]
Abstract
PURPOSE To assess the retinal anatomy and array position in Argus II retinal prosthesis recipients. DESIGN Prospective, noncomparative cohort study. METHODS Setting: International multicenter study. PATIENTS Argus II recipients enrolled in the Post-Market Surveillance Studies. PROCEDURES Spectral-domain optical coherence tomography images collected for the Surveillance Studies (NCT01860092 and NCT01490827) were reviewed. Baseline and postoperative macular thickness, electrode-retina distance (gap), optic disc-array overlap, and preretinal membrane presence were recorded at 1, 3, 6, and 12 months. MAIN OUTCOME MEASURES Axial retinal thickness and axial gap along the array's long axis (a line between the tack and handle); maximal retinal thickness and maximal gap along a B-scan near the tack, midline, and handle. RESULTS Thirty-three patients from 16 surgical sites in the United States and Germany were included. Mean axial retinal thickness increased from month 1 through month 12 at each location, but reached statistical significance only at the array midline (P = .007). The rate of maximal thickness increase was highest near the array midline (slope = 6.02, P = .004), compared to the tack (slope = 3.60, P < .001) or the handle (slope = 1.93, P = .368). The mean axial and maximal gaps decreased over the study period, and the mean maximal gap size decrease was significant at midline (P = .032). Optic disc-array overlap was seen in the minority of patients. Preretinal membranes were common before and after implantation. CONCLUSIONS Progressive macular thickening under the array was common and corresponded to decreased electrode-retina gap over time. By month 12, the array was completely apposed to the macula in approximately half of the eyes.
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