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Bhuckory MB, Wang BY, Chen ZC, Shin A, Pham-Howard D, Shah S, Monkongpitukkul N, Galambos L, Kamins T, Mathieson K, Palanker D. 3D electronic implants in subretinal space: Long-term follow-up in rodents. Biomaterials 2024; 311:122674. [PMID: 38897028 PMCID: PMC11298295 DOI: 10.1016/j.biomaterials.2024.122674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 06/12/2024] [Accepted: 06/15/2024] [Indexed: 06/21/2024]
Abstract
Clinical results with photovoltaic subretinal prosthesis (PRIMA) demonstrated restoration of sight via electrical stimulation of the interneurons in degenerated retina, with resolution matching the 100 μm pixel size. Since scaling the pixels below 75 μm in the current bipolar planar geometry will significantly limit the penetration depth of the electric field and increase stimulation threshold, we explore the possibility of using smaller pixels based on a novel 3-dimensional honeycomb-shaped design. We assessed the long-term biocompatibility and stability of these arrays in rats by investigating the anatomical integration of the retina with flat and 3D implants and response to electrical stimulation over lifetime - up to 32-36 weeks post-implantation in aged rats. With both flat and 3D implants, signals elicited in the visual cortex decreased after the day of implantation by more than 3-fold, and gradually recovered over the next 12-16 weeks. With 25 μm high honeycomb walls, the majority of bipolar cells migrate into the wells, while amacrine and ganglion cells remain above the cavities, which is essential for selective network-mediated stimulation of the retina. Retinal thickness and full-field stimulation threshold with 40 μm-wide honeycomb pixels were comparable to those with planar devices - 0.05 mW/mm2 with 10 ms pulses. However, fewer cells from the inner nuclear layer migrated into the 20 μm-wide wells, and stimulation threshold increased over 12-16 weeks, before stabilizing at about 0.08 mW/mm2. Such threshold is still significantly lower than 1.8 mW/mm2 with a previous design of flat bipolar pixels, confirming the promise of the 3D honeycomb-based approach to high resolution subretinal prosthesis.
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Affiliation(s)
- Mohajeet B Bhuckory
- Department of Ophthalmology, Stanford University, Stanford, CA, USA; Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, USA.
| | - Bing-Yi Wang
- Department of Physics, Stanford University, Stanford, CA, USA
| | - Zhijie C Chen
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
| | - Andrew Shin
- Department of Material Science, Stanford University, Stanford, CA, USA
| | - Davis Pham-Howard
- Department of Ophthalmology, Stanford University, Stanford, CA, USA; Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, USA
| | - Sarthak Shah
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, USA
| | - Nicharee Monkongpitukkul
- Department of Ophthalmology, Stanford University, Stanford, CA, USA; Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, USA
| | - Ludwig Galambos
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, USA
| | - Theodore Kamins
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, USA; Department of Electrical Engineering, Stanford University, Stanford, CA, USA
| | - Keith Mathieson
- Department of Physics, Institute of Photonics, University of Strathclyde, Glasgow, Scotland, UK
| | - Daniel Palanker
- Department of Ophthalmology, Stanford University, Stanford, CA, USA; Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, USA
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Muqit MMK, Le Mer Y, Olmos de Koo L, Holz FG, Sahel JA, Palanker D. Prosthetic Visual Acuity with the PRIMA Subretinal Microchip in Patients with Atrophic Age-Related Macular Degeneration at 4 Years Follow-up. OPHTHALMOLOGY SCIENCE 2024; 4:100510. [PMID: 38881600 PMCID: PMC11179408 DOI: 10.1016/j.xops.2024.100510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/30/2024] [Accepted: 03/04/2024] [Indexed: 06/18/2024]
Abstract
Objective To assess the efficacy and safety of the PRIMA neurostimulation system with a subretinal microchip for improving visual acuity (VA) in patients with geographic atrophy (GA) due to age-related macular degeneration (AMD) at 48-months postimplantation. Design Feasibility clinical trial of the PRIMA subretinal prosthesis in patients with atrophic AMD, measuring best-corrected ETDRS VA (Clinicaltrials.govNCT03333954). Subjects Five patients with GA, no foveal light perception, and VA of logarithm of the minimum angle of resolution (logMAR) 1.3 to 1.7 (20/400-20/1000) in their worse-seeing "study" eye. Methods In patients subretinally implanted with a photovoltaic neurostimulation array containing 378 pixels of 100 μm in size, the VA was measured with and without the PRIMA system using ETDRS charts at 1 m. The system's external components, augmented reality glasses, and pocket computer provide image processing capabilities, including zoom. Main Outcome Measures Visual acuity using ETDRS charts with and without the system, as well as light sensitivity in the central visual field, measured by Octopus perimetry. Anatomical outcomes demonstrated by fundus photography and OCT up to 48 months postimplantation. Results All 5 subjects met the primary end point of light perception elicited by the implant in the scotoma area. In 1 patient, the implant was incorrectly inserted into the choroid. One subject died 18 months postimplantation due to study-unrelated reasons. ETDRS VA results for the remaining 3 subjects are reported here. Without zoom, VA closely matched the pixel size of the implant: 1.17 ± 0.13 pixels, corresponding to a mean logMAR of 1.39, or Snellen of 20/500, ranging from 20/438 to 20/565. Using zoom at 48 months, subjects improved their VA by 32 ETDRS letters versus baseline (standard error 5.1) 95% confidence intervals (13.4, 49.9; P < 0.0001). Natural peripheral visual function in the treated eye did not decline after surgery or during the 48-month follow-up period (P = 0.08). Conclusions Subretinal implantation of PRIMA in subjects with GA experiencing profound vision loss due to AMD is feasible and well tolerated, with no reduction of natural peripheral vision up to 48 months. Prosthetic central vision provided by photovoltaic neurostimulation enabled patients to reliably recognize letters and sequences of letters, and with zoom, it improved VA of up to 8 ETDRS lines. Financial Disclosures Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Mahiul Muhammed Khan Muqit
- Vitreoretinal Service, Moorfields Eye Hospital, London, United Kingdom
- Institute of Ophthalmology, University College London, United Kingdom
| | - Yannick Le Mer
- Department of Ophthalmology, Fondation Ophtalmologique A. de Rothschild, Paris, France
- Clinical Investigation Center, Quinze-Vingts National Eye Hospital, Paris, France
| | - Lisa Olmos de Koo
- Department of Ophthalmology, University of Washington, Seattle, Washington
| | - Frank G. Holz
- Department of Ophthalmology, University of Bonn, Germany
| | - Jose A. Sahel
- Department of Ophthalmology, Fondation Ophtalmologique A. de Rothschild, Paris, France
- Clinical Investigation Center, Quinze-Vingts National Eye Hospital, Paris, France
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Daniel Palanker
- Department of Ophthalmology, Stanford University, Stanford, California
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Yang R, Zhao P, Wang L, Feng C, Peng C, Wang Z, Zhang Y, Shen M, Shi K, Weng S, Dong C, Zeng F, Zhang T, Chen X, Wang S, Wang Y, Luo Y, Chen Q, Chen Y, Jiang C, Jia S, Yu Z, Liu J, Wang F, Jiang S, Xu W, Li L, Wang G, Mo X, Zheng G, Chen A, Zhou X, Jiang C, Yuan Y, Yan B, Zhang J. Assessment of visual function in blind mice and monkeys with subretinally implanted nanowire arrays as artificial photoreceptors. Nat Biomed Eng 2024; 8:1018-1039. [PMID: 37996614 DOI: 10.1038/s41551-023-01137-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 10/17/2023] [Indexed: 11/25/2023]
Abstract
Retinal prostheses could restore image-forming vision in conditions of photoreceptor degeneration. However, contrast sensitivity and visual acuity are often insufficient. Here we report the performance, in mice and monkeys with induced photoreceptor degeneration, of subretinally implanted gold-nanoparticle-coated titania nanowire arrays providing a spatial resolution of 77.5 μm and a temporal resolution of 3.92 Hz in ex vivo retinas (as determined by patch-clamp recording of retinal ganglion cells). In blind mice, the arrays allowed for the detection of drifting gratings and flashing objects at light-intensity thresholds of 15.70-18.09 μW mm-2, and offered visual acuities of 0.3-0.4 cycles per degree, as determined by recordings of visually evoked potentials and optomotor-response tests. In monkeys, the arrays were stable for 54 weeks, allowed for the detection of a 10-μW mm-2 beam of light (0.5° in beam angle) in visually guided saccade experiments, and induced plastic changes in the primary visual cortex, as indicated by long-term in vivo calcium imaging. Nanomaterials as artificial photoreceptors may ameliorate visual deficits in patients with photoreceptor degeneration.
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Affiliation(s)
- Ruyi Yang
- State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, Institutes of Brain Science, Institute for Medical and Engineering Innovation, Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, P. R. China
| | - Peng Zhao
- State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, Institutes of Brain Science, Institute for Medical and Engineering Innovation, Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, P. R. China
| | - Liyang Wang
- Department of Ophthalmology, Zhongshan Hospital, Fudan University, Shanghai, P. R. China
| | - Chenli Feng
- Department of Ophthalmology, Zhongshan Hospital, Fudan University, Shanghai, P. R. China
| | - Chen Peng
- Laboratory of Advanced Materials, Department of Chemistry, Fudan University, Shanghai, P. R. China
| | - Zhexuan Wang
- State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, Institutes of Brain Science, Institute for Medical and Engineering Innovation, Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, P. R. China
| | - Yingying Zhang
- Key Laboratory of Brain Functional Genomics (Ministry of Education), East China Normal University, Shanghai, P. R. China
| | - Minqian Shen
- Department of Ophthalmology, Zhongshan Hospital, Fudan University, Shanghai, P. R. China
| | - Kaiwen Shi
- State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, Institutes of Brain Science, Institute for Medical and Engineering Innovation, Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, P. R. China
| | - Shijun Weng
- State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, Institutes of Brain Science, Institute for Medical and Engineering Innovation, Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, P. R. China
| | - Chunqiong Dong
- Department of Ophthalmology, Zhongshan Hospital, Fudan University, Shanghai, P. R. China
| | - Fu Zeng
- Key Laboratory of Brain Functional Genomics (Ministry of Education), East China Normal University, Shanghai, P. R. China
| | - Tianyun Zhang
- State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, Institutes of Brain Science, Institute for Medical and Engineering Innovation, Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, P. R. China
| | - Xingdong Chen
- State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, Institutes of Brain Science, Institute for Medical and Engineering Innovation, Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, P. R. China
| | - Shuiyuan Wang
- Shanghai Key Lab for Future Computing Hardware and System, School of Microelectronics, Fudan University, Shanghai, P. R. China
| | - Yiheng Wang
- State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, Institutes of Brain Science, Institute for Medical and Engineering Innovation, Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, P. R. China
| | - Yuanyuan Luo
- State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, Institutes of Brain Science, Institute for Medical and Engineering Innovation, Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, P. R. China
| | - Qingyuan Chen
- State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, Institutes of Brain Science, Institute for Medical and Engineering Innovation, Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, P. R. China
| | - Yuqing Chen
- State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, Institutes of Brain Science, Institute for Medical and Engineering Innovation, Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, P. R. China
| | - Chengyong Jiang
- State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, Institutes of Brain Science, Institute for Medical and Engineering Innovation, Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, P. R. China
| | - Shanshan Jia
- School of Computer Science, Institute for Artificial Intelligence, Peking University, Beijing, P.R. China
| | - Zhaofei Yu
- School of Computer Science, Institute for Artificial Intelligence, Peking University, Beijing, P.R. China
| | - Jian Liu
- School of Computer Science, University of Birmingham, Birmingham, UK
| | - Fei Wang
- Department of Hand Surgery, the National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, P. R. China
| | - Su Jiang
- Department of Hand Surgery, the National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, P. R. China
| | - Wendong Xu
- Department of Hand Surgery, the National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, P. R. China
- Department of Hand and Upper Extremity Surgery, Jing'an District Central Hospital, Fudan University, Shanghai, P.R. China
| | - Liang Li
- Center of Brain Sciences, Beijing Institute of Basic Medical Sciences, Beijing, P. R. China
| | - Gang Wang
- Center of Brain Sciences, Beijing Institute of Basic Medical Sciences, Beijing, P. R. China
| | - Xiaofen Mo
- State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, Institutes of Brain Science, Institute for Medical and Engineering Innovation, Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, P. R. China
| | - Gengfeng Zheng
- Laboratory of Advanced Materials, Department of Chemistry, Fudan University, Shanghai, P. R. China
| | - Aihua Chen
- Key Laboratory of Brain Functional Genomics (Ministry of Education), East China Normal University, Shanghai, P. R. China
| | - Xingtao Zhou
- State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, Institutes of Brain Science, Institute for Medical and Engineering Innovation, Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, P. R. China
| | - Chunhui Jiang
- State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, Institutes of Brain Science, Institute for Medical and Engineering Innovation, Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, P. R. China.
| | - Yuanzhi Yuan
- Department of Ophthalmology, Zhongshan Hospital, Fudan University, Shanghai, P. R. China.
- Zhongshan Hospital (Xiamen), Fudan University, Xiamen, P.R. China.
| | - Biao Yan
- State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, Institutes of Brain Science, Institute for Medical and Engineering Innovation, Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, P. R. China.
| | - Jiayi Zhang
- State Key Laboratory of Medical Neurobiology, MOE Frontiers Center for Brain Science, Institutes of Brain Science, Institute for Medical and Engineering Innovation, Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, P. R. China.
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Jensen N, Charles Chen Z, Kochnev Goldstein A, Palanker D. Accelerated Simulation of Multi-Electrode Arrays Using Sparse and Low-Rank Matrix Techniques. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.07.29.605687. [PMID: 39131271 PMCID: PMC11312517 DOI: 10.1101/2024.07.29.605687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Abstract
Modeling of Multi-Electrode Arrays used in neural stimulation can be computationally challenging since it may involve incredibly dense circuits with millions of interconnected resistors, representing current pathways in an electrolyte (resistance matrix), coupled to nonlinear circuits of the stimulating pixels themselves. Here, we present a method for accelerating the modeling of such circuits while minimizing the error of a simplified simulation by using a sparse plus low-rank approximation of the resistance matrix. Specifically, we prove that thresholding of the resistance matrix elements enables its sparsification with minimized error. This is accomplished with a sorting algorithm implying efficient O (N log (N)) complexity. The eigenvalue-based low-rank compensation then helps achieve greater accuracy without adding significantly to the problem size. Utilizing these matrix techniques, we accelerated the simulation of multi-electrode arrays by an order of magnitude, reducing the computation time by about 10-fold, while maintaining an average error of less than 0.3% in the current injected from each electrode. We also show a case where acceleration reaches at least 133 times with additional error in the range of 4%, demonstrating the ability of this algorithm to perform under extreme conditions. Although the techniques presented here are used for simulations of photovoltaic retinal prostheses, they are also immediately applicable to any circuit involving dense connections between nodes, and, with modifications, more generally to any systems involving non-sparse matrices. This approach promises significant improvements in the efficiency of modeling the next-generation retinal implants having thousands of pixels, enabling iterative design with broad applicability.
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Affiliation(s)
- Nathan Jensen
- Department of Electrical Engineering, Stanford University, Stanford, CA 94305 USA
| | - Zhijie Charles Chen
- Department of Electrical Engineering, Stanford University, Stanford, CA 94305 USA
| | | | - Daniel Palanker
- Department of Ophthalmology and Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA 94305 USA
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5
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Chung WG, Jang J, Cui G, Lee S, Jeong H, Kang H, Seo H, Kim S, Kim E, Lee J, Lee SG, Byeon SH, Park JU. Liquid-metal-based three-dimensional microelectrode arrays integrated with implantable ultrathin retinal prosthesis for vision restoration. NATURE NANOTECHNOLOGY 2024; 19:688-697. [PMID: 38225357 PMCID: PMC11106006 DOI: 10.1038/s41565-023-01587-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 11/28/2023] [Indexed: 01/17/2024]
Abstract
Electronic retinal prostheses for stimulating retinal neurons are promising for vision restoration. However, the rigid electrodes of conventional retinal implants can inflict damage on the soft retina tissue. They also have limited selectivity due to their poor proximity to target cells in the degenerative retina. Here we present a soft artificial retina (thickness, 10 μm) where flexible ultrathin photosensitive transistors are integrated with three-dimensional stimulation electrodes of eutectic gallium-indium alloy. Platinum nanoclusters locally coated only on the tip of these three-dimensional liquid-metal electrodes show advantages in reducing the impedance of the stimulation electrodes. These microelectrodes can enhance the proximity to the target retinal ganglion cells and provide effective charge injections (72.84 mC cm-2) to elicit neural responses in the retina. Their low Young's modulus (234 kPa), owing to their liquid form, can minimize damage to the retina. Furthermore, we used an unsupervised machine learning approach to effectively identify the evoked spikes to grade neural activities within the retinal ganglion cells. Results from in vivo experiments on a retinal degeneration mouse model reveal that the spatiotemporal distribution of neural responses on their retina can be mapped under selective localized illumination areas of light, suggesting the restoration of their vision.
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Affiliation(s)
- Won Gi Chung
- Department of Materials Science & Engineering, Yonsei University, Seoul, Republic of Korea
- Center for Nanomedicine, Institute for Basic Science (IBS), Seoul, Republic of Korea
- Graduate Program of Nano Biomedical Engineering (NanoBME), Advanced Science Institute, Yonsei University, Seoul, Republic of Korea
| | - Jiuk Jang
- Department of Materials Science & Engineering, Yonsei University, Seoul, Republic of Korea
- Center for Nanomedicine, Institute for Basic Science (IBS), Seoul, Republic of Korea
- Graduate Program of Nano Biomedical Engineering (NanoBME), Advanced Science Institute, Yonsei University, Seoul, Republic of Korea
| | - Gang Cui
- Institute of Vision Research, Department of Ophthalmology, Severance Eye Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sanghoon Lee
- Department of Materials Science & Engineering, Yonsei University, Seoul, Republic of Korea
- Center for Nanomedicine, Institute for Basic Science (IBS), Seoul, Republic of Korea
- Graduate Program of Nano Biomedical Engineering (NanoBME), Advanced Science Institute, Yonsei University, Seoul, Republic of Korea
| | - Han Jeong
- Institute of Vision Research, Department of Ophthalmology, Severance Eye Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
- Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Haisu Kang
- School of Chemical Engineering, Pusan National University, Busan, Republic of Korea
| | - Hunkyu Seo
- Department of Materials Science & Engineering, Yonsei University, Seoul, Republic of Korea
- Center for Nanomedicine, Institute for Basic Science (IBS), Seoul, Republic of Korea
- Graduate Program of Nano Biomedical Engineering (NanoBME), Advanced Science Institute, Yonsei University, Seoul, Republic of Korea
| | - Sumin Kim
- Department of Materials Science & Engineering, Yonsei University, Seoul, Republic of Korea
- Center for Nanomedicine, Institute for Basic Science (IBS), Seoul, Republic of Korea
- Graduate Program of Nano Biomedical Engineering (NanoBME), Advanced Science Institute, Yonsei University, Seoul, Republic of Korea
| | - Enji Kim
- Department of Materials Science & Engineering, Yonsei University, Seoul, Republic of Korea
- Center for Nanomedicine, Institute for Basic Science (IBS), Seoul, Republic of Korea
- Graduate Program of Nano Biomedical Engineering (NanoBME), Advanced Science Institute, Yonsei University, Seoul, Republic of Korea
| | - Junwon Lee
- Institute of Vision Research, Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seung Geol Lee
- School of Chemical Engineering, Pusan National University, Busan, Republic of Korea.
- Department of Organic Material Science and Engineering, Pusan National University, Busan, Republic of Korea.
| | - Suk Ho Byeon
- Institute of Vision Research, Department of Ophthalmology, Severance Eye Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
- Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
| | - Jang-Ung Park
- Department of Materials Science & Engineering, Yonsei University, Seoul, Republic of Korea.
- Center for Nanomedicine, Institute for Basic Science (IBS), Seoul, Republic of Korea.
- Graduate Program of Nano Biomedical Engineering (NanoBME), Advanced Science Institute, Yonsei University, Seoul, Republic of Korea.
- Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Bhuckory MB, Monkongpitukkul N, Shin A, Goldstein AK, Jensen N, Shah SV, Pham-Howard D, Butt E, Dalal R, Galambos L, Mathieson K, Kamins T, Palanker D. Enhancing Prosthetic Vision by Upgrade of a Subretinal Photovoltaic Implant in situ. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.15.589465. [PMID: 38659843 PMCID: PMC11042236 DOI: 10.1101/2024.04.15.589465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
In patients with atrophic age-related macular degeneration, subretinal photovoltaic implant (PRIMA) provided visual acuity up to 20/440, matching its 100μm pixels size. Next-generation implants with smaller pixels should significantly improve the acuity. This study in rats evaluates removal of a subretinal implant, replacement with a newer device, and the resulting grating acuity in-vivo. Six weeks after the initial implantation with planar and 3-dimensional devices, the retina was re-detached, and the devices were successfully removed. Histology demonstrated a preserved inner nuclear layer. Re-implantation of new devices into the same location demonstrated retinal re-attachment to a new implant. New devices with 22μm pixels increased the grating acuity from the 100μm capability of PRIMA implants to 28μm, reaching the limit of natural resolution in rats. Reimplanted devices exhibited the same stimulation threshold as for the first implantation of the same implants in a control group. This study demonstrates the feasibility of safely upgrading the subretinal photovoltaic implants to improve prosthetic visual acuity.
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Affiliation(s)
- Mohajeet B Bhuckory
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA 94303, USA
- Department of Ophthalmology, Stanford University, Stanford, CA, USA
| | - Nicharee Monkongpitukkul
- Department of Ophthalmology, Stanford University, Stanford, CA, USA
- Department of Ophthalmology, Faculty of Medicine, Prince of Songkla University, Thailand
| | - Andrew Shin
- Department of Material Science, Stanford University, Stanford, CA, USA
| | | | - Nathan Jensen
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
| | - Sarthak V Shah
- Department of Ophthalmology, Stanford University, Stanford, CA, USA
| | - Davis Pham-Howard
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA 94303, USA
- Department of Ophthalmology, Stanford University, Stanford, CA, USA
| | - Emma Butt
- Department of Physics, University of Strathclyde, Glasgow, Scotland, UK
| | - Roopa Dalal
- Department of Ophthalmology, Stanford University, Stanford, CA, USA
| | - Ludwig Galambos
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA 94303, USA
| | - Keith Mathieson
- Department of Physics, University of Strathclyde, Glasgow, Scotland, UK
| | - Theodore Kamins
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
| | - Daniel Palanker
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA 94303, USA
- Department of Ophthalmology, Stanford University, Stanford, CA, USA
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Stoddart PR, Begeng JM, Tong W, Ibbotson MR, Kameneva T. Nanoparticle-based optical interfaces for retinal neuromodulation: a review. Front Cell Neurosci 2024; 18:1360870. [PMID: 38572073 PMCID: PMC10987880 DOI: 10.3389/fncel.2024.1360870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 03/04/2024] [Indexed: 04/05/2024] Open
Abstract
Degeneration of photoreceptors in the retina is a leading cause of blindness, but commonly leaves the retinal ganglion cells (RGCs) and/or bipolar cells extant. Consequently, these cells are an attractive target for the invasive electrical implants colloquially known as "bionic eyes." However, after more than two decades of concerted effort, interfaces based on conventional electrical stimulation approaches have delivered limited efficacy, primarily due to the current spread in retinal tissue, which precludes high-acuity vision. The ideal prosthetic solution would be less invasive, provide single-cell resolution and an ability to differentiate between different cell types. Nanoparticle-mediated approaches can address some of these requirements, with particular attention being directed at light-sensitive nanoparticles that can be accessed via the intrinsic optics of the eye. Here we survey the available known nanoparticle-based optical transduction mechanisms that can be exploited for neuromodulation. We review the rapid progress in the field, together with outstanding challenges that must be addressed to translate these techniques to clinical practice. In particular, successful translation will likely require efficient delivery of nanoparticles to stable and precisely defined locations in the retinal tissues. Therefore, we also emphasize the current literature relating to the pharmacokinetics of nanoparticles in the eye. While considerable challenges remain to be overcome, progress to date shows great potential for nanoparticle-based interfaces to revolutionize the field of visual prostheses.
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Affiliation(s)
- Paul R. Stoddart
- School of Science, Computing and Engineering Technologies, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - James M. Begeng
- School of Science, Computing and Engineering Technologies, Swinburne University of Technology, Hawthorn, VIC, Australia
- Department of Biomedical Engineering, Faculty of Engineering & Information Technology, The University of Melbourne, Melbourne, VIC, Australia
| | - Wei Tong
- Department of Biomedical Engineering, Faculty of Engineering & Information Technology, The University of Melbourne, Melbourne, VIC, Australia
- School of Physics, The University of Melbourne, Melbourne, VIC, Australia
| | - Michael R. Ibbotson
- Department of Biomedical Engineering, Faculty of Engineering & Information Technology, The University of Melbourne, Melbourne, VIC, Australia
| | - Tatiana Kameneva
- School of Science, Computing and Engineering Technologies, Swinburne University of Technology, Hawthorn, VIC, Australia
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Seo HW, Cha S, Jeong Y, Ahn J, Lee KJ, Kim S, Goo YS. Focal stimulation of retinal ganglion cells using subretinal 3D microelectrodes with peripheral electrodes of opposite current. Biomed Eng Lett 2024; 14:355-365. [PMID: 38374901 PMCID: PMC10874361 DOI: 10.1007/s13534-023-00342-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 10/10/2023] [Accepted: 12/07/2023] [Indexed: 02/21/2024] Open
Abstract
Subretinal prostheses have been developed to stimulate survived retinal ganglion cells (RGCs), indirectly following the physiological visual pathways. However, current spreading from the prosthesis electrode causes the activation of unintended RGCs, thereby limiting the spatial resolution of artificial vision. This study proposes a strategy for focal stimulation of RGCs using a subretinal electrode array, in which six hexagonally arranged peripheral electrodes surround a stimulating electrode. RGCs in an in-vitro condition were subretinally stimulated using a fabricated electrode array coated with iridium oxide, following the three different stimulation configurations (with no peripheral, six electrodes of opposite current, and six ground). In-vitro experiments showed that the stimulation with six electrodes of opposite current was most effective in controlling RGC responses with a high spatial resolution. The results suggest that the effective utilization of return electrodes, such as by applying an opposite current to them, could help reduce current spreading beyond the local area targeted for stimulation and elicit RGC responses only in the vicinity of the stimulating electrode. Supplementary Information The online version contains supplementary material available at 10.1007/s13534-023-00342-3.
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Affiliation(s)
- Hee Won Seo
- Department of Robotics and Mechatronics Engineering, Daegu Gyeongbuk Institute of Science and Technology (DGIST), Daegu, Republic of Korea
| | - Seongkwang Cha
- Department of Physiology, Chungbuk National University School of Medicine, Cheongju, Republic of Korea
| | - Yurim Jeong
- Department of Physiology, Chungbuk National University School of Medicine, Cheongju, Republic of Korea
| | - Jungryul Ahn
- Department of Physiology, Chungbuk National University School of Medicine, Cheongju, Republic of Korea
| | - Kyeong Jae Lee
- Department of Robotics and Mechatronics Engineering, Daegu Gyeongbuk Institute of Science and Technology (DGIST), Daegu, Republic of Korea
| | - Sohee Kim
- Department of Robotics and Mechatronics Engineering, Daegu Gyeongbuk Institute of Science and Technology (DGIST), Daegu, Republic of Korea
| | - Yong Sook Goo
- Department of Physiology, Chungbuk National University School of Medicine, Cheongju, Republic of Korea
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Butt E, Wang BY, Shin A, Chen ZC, Bhuckory M, Shah S, Galambos L, Kamins T, Palanker D, Mathieson K. Three-dimensional electro-neural interfaces electroplated on subretinal prostheses. J Neural Eng 2024; 21:016030. [PMID: 38364290 PMCID: PMC10884765 DOI: 10.1088/1741-2552/ad2a37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/26/2024] [Accepted: 02/16/2024] [Indexed: 02/18/2024]
Abstract
Objective.Retinal prosthetics offer partial restoration of sight to patients blinded by retinal degenerative diseases through electrical stimulation of the remaining neurons. Decreasing the pixel size enables increasing prosthetic visual acuity, as demonstrated in animal models of retinal degeneration. However, scaling down the size of planar pixels is limited by the reduced penetration depth of the electric field in tissue. We investigated 3-dimensional (3d) structures on top of photovoltaic arrays for enhanced penetration of the electric field, permitting higher resolution implants.Approach.3D COMSOL models of subretinal photovoltaic arrays were developed to accurately quantify the electrodynamics during stimulation and verified through comparison to flat photovoltaic arrays. Models were applied to optimize the design of 3D electrode structures (pillars and honeycombs). Return electrodes on honeycomb walls vertically align the electric field with bipolar cells for optimal stimulation. Pillars elevate the active electrode, thus improving proximity to target neurons. The optimized 3D structures were electroplated onto existing flat subretinal prostheses.Main results.Simulations demonstrate that despite exposed conductive sidewalls, charge mostly flows via high-capacitance sputtered iridium oxide films topping the 3D structures. The 24μm height of honeycomb structures was optimized for integration with the inner nuclear layer cells in the rat retina, whilst 35μm tall pillars were optimized for penetrating the debris layer in human patients. Implantation of released 3D arrays demonstrates mechanical robustness, with histology demonstrating successful integration of 3D structures with the rat retinain-vivo.Significance. Electroplated 3D honeycomb structures produce vertically oriented electric fields, providing low stimulation thresholds, high spatial resolution, and high contrast for pixel sizes down to 20μm. Pillar electrodes offer an alternative for extending past the debris layer. Electroplating of 3D structures is compatible with the fabrication process of flat photovoltaic arrays, enabling much more efficient retinal stimulation.
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Affiliation(s)
- Emma Butt
- Institute of Photonics, Department of Physics, University of Strathclyde, Glasgow, United Kingdom
| | - Bing-Yi Wang
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, United States of America
- Department of Physics, Stanford University, Stanford, CA, United States of America
| | - Andrew Shin
- Department of Materials Science and Engineering, Stanford University, Stanford, CA, United States of America
| | - Zhijie Charles Chen
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, United States of America
- Department of Electrical Engineering, Stanford University, Stanford, CA, United States of America
| | - Mohajeet Bhuckory
- Department of Ophthalmology, Stanford University, Stanford, CA, United States of America
| | - Sarthak Shah
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, United States of America
| | - Ludwig Galambos
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, United States of America
- Department of Electrical Engineering, Stanford University, Stanford, CA, United States of America
| | - Theodore Kamins
- Department of Electrical Engineering, Stanford University, Stanford, CA, United States of America
| | - Daniel Palanker
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, United States of America
- Department of Ophthalmology, Stanford University, Stanford, CA, United States of America
| | - Keith Mathieson
- Institute of Photonics, Department of Physics, University of Strathclyde, Glasgow, United Kingdom
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10
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Richie J, Letner JG, Mclane-Svoboda A, Huan Y, Ghaffari DH, Valle ED, Patel PR, Chiel HJ, Pelled G, Weiland JD, Chestek CA. Fabrication and Validation of Sub-Cellular Carbon Fiber Electrodes. IEEE Trans Neural Syst Rehabil Eng 2024; 32:739-749. [PMID: 38294928 PMCID: PMC10919889 DOI: 10.1109/tnsre.2024.3360866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
Multielectrode arrays for interfacing with neurons are of great interest for a wide range of medical applications. However, current electrodes cause damage over time. Ultra small carbon fibers help to address issues but controlling the electrode site geometry is difficult. Here we propose a methodology to create small, pointed fiber electrodes (SPFe). We compare the SPFe to previously made blowtorched fibers in characterization. The SPFe result in small site sizes [Formula: see text] with consistently sharp points (20.8 ± 7.64°). Additionally, these electrodes were able to record and/or stimulate neurons multiple animal models including rat cortex, mouse retina, Aplysia ganglia and octopus axial cord. In rat cortex, these electrodes recorded significantly higher peak amplitudes than the traditional blowtorched fibers. These SPFe may be applicable to a wide range of applications requiring a highly specific interface with individual neurons.
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11
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Muqit M, Mer YL, de Koo LO, Holz FG, Sahel JA, Palanker D. Prosthetic Visual Acuity with the PRIMA System in Patients with Atrophic Age-related Macular Degeneration at 4 years follow-up. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.11.12.23298227. [PMID: 38014146 PMCID: PMC10680875 DOI: 10.1101/2023.11.12.23298227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Objective To assess the efficacy and safety of the PRIMA subretinal neurostimulation system 48-months post-implantation for improving visual acuity (VA) in patients with geographic atrophy (GA) due to age-related macular degeneration (AMD) at 48-months post-implantation. Design First-in-human clinical trial of the PRIMA subretinal prosthesis in patients with atrophic AMD, measuring best-corrected ETDRS VA (Clinicaltrials.gov NCT03333954). Subjects Five patients with GA, no foveal light perception and VA of logMAR 1.3 to 1.7 in their worse-seeing "study" eye. Methods In patients implanted with a subretinal photovoltaic neurostimulation array containing 378 pixels of 100 μm in size, the VA was measured with and without the PRIMA system using ETDRS charts at 1 meter. The system's external components: augmented reality glasses and pocket computer, provide image processing capabilities, including zoom. Main Outcome Measures VA using ETDRS charts with and without the system. Light sensitivity in the central visual field, as measured by Octopus perimetry. Anatomical outcomes demonstrated by fundus photography and optical coherence tomography up to 48-months post-implantation. Results All five subjects met the primary endpoint of light perception elicited by the implant in the scotoma area. In one patient the implant was incorrectly inserted into the choroid. One subject died 18-months post-implantation due to study-unrelated reason. ETDRS VA results for the remaining three subjects are reported herein. Without zoom, VA closely matched the pixel size of the implant: 1.17 ± 0.13 pixels, corresponding to mean logMAR 1.39, or Snellen 20/500, ranging from 20/438 to 20/565. Using zoom at 48 months, subjects improved their VA by 32 ETDRS letters versus baseline (SE 5.1) 95% CI[13.4,49.9], p<0.0001. Natural peripheral visual function in the treated eye did not decline after surgery compared to the fellow eye (p=0.08) during the 48 months follow-up period. Conclusions Subretinal implantation of PRIMA in subjects with GA suffering from profound vision loss due to AMD is feasible and well tolerated, with no reduction of natural peripheral vision up to 48-months. Using prosthetic central vision through photovoltaic neurostimulation, patients reliably recognized letters and sequences of letters,and with zoom it provided a clinically meaningful improvement in VA of up to eight ETDRS lines.
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Affiliation(s)
- Mmk Muqit
- Vitreoretinal Service, Moorfields Eye Hospital, London, UK
- Institute of Ophthalmology, University College London, UK
| | - Y Le Mer
- Department of Ophthalmology, Fondation Ophtalmologique A. de Rothschild, Paris, France
- Clinical Investigation Center, Quinze-Vingts National Eye Hospital, Paris, France
| | - L Olmos de Koo
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - F G Holz
- Department of Ophthalmology, University of Bonn, Germany
| | - J A Sahel
- Department of Ophthalmology, Fondation Ophtalmologique A. de Rothschild, Paris, France
- Clinical Investigation Center, Quinze-Vingts National Eye Hospital, Paris, France
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - D Palanker
- Department of Ophthalmology, Stanford University, Stanford, CA, USA
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Butt E, Wang BY, Shin A, Chen ZC, Bhuckory M, Shah S, Galambos L, Kamins T, Palanker D, Mathieson K. Three-dimensional electro-neural interfaces electroplated on subretinal prostheses. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.11.09.566003. [PMID: 38014082 PMCID: PMC10680680 DOI: 10.1101/2023.11.09.566003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Objective High-resolution retinal prosthetics offer partial restoration of sight to patients blinded by retinal degenerative diseases through electrical stimulation of the remaining neurons. Decreasing the pixel size enables an increase in prosthetic visual acuity, as demonstrated in animal models of retinal degeneration. However, scaling down the size of planar pixels is limited by the reduced penetration depth of the electric field in tissue. We investigate 3-dimensional structures on top of the photovoltaic arrays for enhanced penetration of electric field to permit higher-resolution implants. Approach We developed 3D COMSOL models of subretinal photovoltaic arrays that accurately quantify the device electrodynamics during stimulation and verified it experimentally through comparison with the standard (flat) photovoltaic arrays. The models were then applied to optimise the design of 3D electrode structures (pillars and honeycombs) to efficiently stimulate the inner retinal neurons. The return electrodes elevated on top of the honeycomb walls surrounding each pixel orient the electric field inside the cavities vertically, aligning it with bipolar cells for optimal stimulation. Alternatively, pillars elevate the active electrode into the inner nuclear layer, improving proximity to the target neurons. Modelling results informed a microfabrication process of electroplating the 3D electrode structures on top of the existing flat subretinal prosthesis. Main results Simulations demonstrate that despite the conductive sidewalls of the 3D electrodes being exposed to electrolyte, most of the charge flows via the high-capacitance sputtered Iridium Oxide film that caps the top of the 3D structures. The 24 μm height of the electroplated honeycomb structures was optimised for integration with the inner nuclear layer cells in rat retina, while 35 μm height of the pillars was optimized for penetrating the debris layer in human patients. Release from the wafer and implantation of the 3D arrays demonstrated that they are mechanically robust to withstand the associated forces. Histology demonstrated successful integration of the 3D structures with the rat retina in-vivo. Significance Electroplated 3D honeycomb structures produce a vertically oriented electric field that offers low stimulation threshold, high spatial resolution and high contrast for the retinal implants with pixel sizes down to 20μm in width. Pillar electrodes offer an alternative configuration for extending the stimulation past the debris layers. Electroplating of the 3D structures is compatible with the fabrication process of the flat photovoltaic arrays, thereby enabling much more efficient stimulation than in their original flat configuration.
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Affiliation(s)
- Emma Butt
- Institute of Photonics, Department of Physics, University of Strathclyde, Glasgow, Scotland, UK
| | - Bing-Yi Wang
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, USA
- Department of Physics, Stanford University, Stanford, CA, USA
| | - Andrew Shin
- Department of Materials Science and Engineering, Stanford, CA, USA
| | - Zhijie Charles Chen
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, USA
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
| | | | - Sarthak Shah
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, USA
| | - Ludwig Galambos
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, USA
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
| | - Theodore Kamins
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
| | - Daniel Palanker
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, USA
- Department of Ophthalmology, Stanford University, Stanford, CA, USA
| | - Keith Mathieson
- Institute of Photonics, Department of Physics, University of Strathclyde, Glasgow, Scotland, UK
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Bhuckory MB, Wang BY, Chen ZC, Shin A, Huang T, Galambos L, Vounotrypidis E, Mathieson K, Kamins T, Palanker D. Cellular migration into a subretinal honeycomb-shaped prosthesis for high-resolution prosthetic vision. Proc Natl Acad Sci U S A 2023; 120:e2307380120. [PMID: 37831740 PMCID: PMC10589669 DOI: 10.1073/pnas.2307380120] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 09/08/2023] [Indexed: 10/15/2023] Open
Abstract
In patients blinded by geographic atrophy, a subretinal photovoltaic implant with 100 µm pixels provided visual acuity closely matching the pixel pitch. However, such flat bipolar pixels cannot be scaled below 75 µm, limiting the attainable visual acuity. This limitation can be overcome by shaping the electric field with 3-dimensional (3-D) electrodes. In particular, elevating the return electrode on top of the honeycomb-shaped vertical walls surrounding each pixel extends the electric field vertically and decouples its penetration into tissue from the pixel width. This approach relies on migration of the retinal cells into the honeycomb wells. Here, we demonstrate that majority of the inner retinal neurons migrate into the 25 µm deep wells, leaving the third-order neurons, such as amacrine and ganglion cells, outside. This enables selective stimulation of the second-order neurons inside the wells, thus preserving the intraretinal signal processing in prosthetic vision. Comparable glial response to that with flat implants suggests that migration and separation of the retinal cells by the walls does not cause additional stress. Furthermore, retinal migration into the honeycombs does not negatively affect its electrical excitability, while grating acuity matches the pixel pitch down to 40 μm and reaches the 27 μm limit of natural resolution in rats with 20 μm pixels. These findings pave the way for 3-D subretinal prostheses with pixel sizes of cellular dimensions.
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Affiliation(s)
- Mohajeet B. Bhuckory
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA94305
- Department of Ophthalmology, Stanford University, Stanford, CA94305
| | - Bing-Yi Wang
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA94305
- Department of Physics, Stanford University, Stanford, CA94305
| | - Zhijie Charles Chen
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA94305
- Department of Electrical Engineering, Stanford University, Stanford, CA94305
| | - Andrew Shin
- Department of Material Science, Stanford University, Stanford, CA94305
| | - Tiffany Huang
- Department of Electrical Engineering, Stanford University, Stanford, CA94305
| | - Ludwig Galambos
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA94305
| | | | - Keith Mathieson
- Department of Physics, University of Strathclyde, G1 1XQGlasgow, Scotland, United Kingdom
| | - Theodore Kamins
- Department of Electrical Engineering, Stanford University, Stanford, CA94305
| | - Daniel Palanker
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA94305
- Department of Ophthalmology, Stanford University, Stanford, CA94305
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14
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Kerschensteiner D. Losing, preserving, and restoring vision from neurodegeneration in the eye. Curr Biol 2023; 33:R1019-R1036. [PMID: 37816323 PMCID: PMC10575673 DOI: 10.1016/j.cub.2023.08.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
The retina is a part of the brain that sits at the back of the eye, looking out onto the world. The first neurons of the retina are the rod and cone photoreceptors, which convert changes in photon flux into electrical signals that are the basis of vision. Rods and cones are frequent targets of heritable neurodegenerative diseases that cause visual impairment, including blindness, in millions of people worldwide. This review summarizes the diverse genetic causes of inherited retinal degenerations (IRDs) and their convergence onto common pathogenic mechanisms of vision loss. Currently, there are few effective treatments for IRDs, but recent advances in disparate areas of biology and technology (e.g., genome editing, viral engineering, 3D organoids, optogenetics, semiconductor arrays) discussed here enable promising efforts to preserve and restore vision in IRD patients with implications for neurodegeneration in less approachable brain areas.
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Affiliation(s)
- Daniel Kerschensteiner
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, MO 63110, USA; Department of Neuroscience, Washington University School of Medicine, St. Louis, MO 63110, USA; Department of Biomedical Engineering, Washington University School of Medicine, St. Louis, MO 63110, USA.
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15
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Son Y, Chen ZC, Roh H, Lee BC, Im M. Effects on Retinal Stimulation of the Geometry and the Insertion Location of Penetrating Electrodes. IEEE Trans Neural Syst Rehabil Eng 2023; 31:3803-3812. [PMID: 37729573 DOI: 10.1109/tnsre.2023.3317496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
Retinal implants have been developed and implanted to restore vision from outer retinal degeneration, but their performance is still limited due to the poor spatial resolution. To improve the localization of stimulation, microelectrodes in various three-dimensional (3D) shapes have been investigated. In particular, computational simulation is crucial for optimizing the performance of a novel microelectrode design before actual fabrication. However, most previous studies have assumed a uniform conductivity for the entire retina without testing the effect of electrodes placement in different layers. In this study, we used the finite element method to simulate electric fields created by 3D microelectrodes of three different designs in a retina model with a stratified conductivity profile. The three electrode designs included two conventional shapes - a conical electrode (CE) and a pillar electrode (PE); we also proposed a novel structure of pillar electrode with an insulating wall (PEIW). A quantitative comparison of these designs shows the PEIW generates a stronger and more confined electric field with the same current injection, which is preferred for high-resolution retinal prostheses. Moreover, our results demonstrate both the magnitude and the shape of potential distribution generated by a penetrating electrode depend not only on the geometry, but also substantially on the insertion depth of the electrode. Although epiretinal insertions are mainly discussed, we also compared results for subretinal insertions. The results provide valuable insights for improving the spatial resolution of retinal implants using 3D penetrating microelectrodes and highlight the importance of considering the heterogeneity of conductivities in the retina.
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16
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Almasri RM, Ladouceur F, Mawad D, Esrafilzadeh D, Firth J, Lehmann T, Poole-Warren LA, Lovell NH, Al Abed A. Emerging trends in the development of flexible optrode arrays for electrophysiology. APL Bioeng 2023; 7:031503. [PMID: 37692375 PMCID: PMC10491464 DOI: 10.1063/5.0153753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 08/08/2023] [Indexed: 09/12/2023] Open
Abstract
Optical-electrode (optrode) arrays use light to modulate excitable biological tissues and/or transduce bioelectrical signals into the optical domain. Light offers several advantages over electrical wiring, including the ability to encode multiple data channels within a single beam. This approach is at the forefront of innovation aimed at increasing spatial resolution and channel count in multichannel electrophysiology systems. This review presents an overview of devices and material systems that utilize light for electrophysiology recording and stimulation. The work focuses on the current and emerging methods and their applications, and provides a detailed discussion of the design and fabrication of flexible arrayed devices. Optrode arrays feature components non-existent in conventional multi-electrode arrays, such as waveguides, optical circuitry, light-emitting diodes, and optoelectronic and light-sensitive functional materials, packaged in planar, penetrating, or endoscopic forms. Often these are combined with dielectric and conductive structures and, less frequently, with multi-functional sensors. While creating flexible optrode arrays is feasible and necessary to minimize tissue-device mechanical mismatch, key factors must be considered for regulatory approval and clinical use. These include the biocompatibility of optical and photonic components. Additionally, material selection should match the operating wavelength of the specific electrophysiology application, minimizing light scattering and optical losses under physiologically induced stresses and strains. Flexible and soft variants of traditionally rigid photonic circuitry for passive optical multiplexing should be developed to advance the field. We evaluate fabrication techniques against these requirements. We foresee a future whereby established telecommunications techniques are engineered into flexible optrode arrays to enable unprecedented large-scale high-resolution electrophysiology systems.
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Affiliation(s)
- Reem M. Almasri
- Graduate School of Biomedical Engineering, UNSW, Sydney, NSW 2052, Australia
| | | | - Damia Mawad
- School of Materials Science and Engineering, UNSW, Sydney, NSW 2052, Australia
| | - Dorna Esrafilzadeh
- Graduate School of Biomedical Engineering, UNSW, Sydney, NSW 2052, Australia
| | - Josiah Firth
- Australian National Fabrication Facility, UNSW, Sydney, NSW 2052, Australia
| | - Torsten Lehmann
- School of Electrical Engineering and Telecommunications, UNSW, Sydney, NSW 2052, Australia
| | | | | | - Amr Al Abed
- Graduate School of Biomedical Engineering, UNSW, Sydney, NSW 2052, Australia
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17
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Palanker D. Electronic Retinal Prostheses. Cold Spring Harb Perspect Med 2023; 13:a041525. [PMID: 36781222 PMCID: PMC10411866 DOI: 10.1101/cshperspect.a041525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
Retinal prostheses are a promising means for restoring sight to patients blinded by photoreceptor atrophy. They introduce visual information by electrical stimulation of the surviving inner retinal neurons. Subretinal implants target the graded-response secondary neurons, primarily the bipolar cells, which then transfer the information to the ganglion cells via the retinal neural network. Therefore, many features of natural retinal signal processing can be preserved in this approach if the inner retinal network is retained. Epiretinal implants stimulate primarily the ganglion cells, and hence should encode the visual information in spiking patterns, which, ideally, should match the target cell types. Currently, subretinal arrays are being developed primarily for restoration of central vision in patients impaired by age-related macular degeneration (AMD), while epiretinal implants-for patients blinded by retinitis pigmentosa, where the inner retina is less preserved. This review describes the concepts and technologies, preclinical characterization of prosthetic vision and clinical outcomes, and provides a glimpse into future developments.
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Affiliation(s)
- Daniel Palanker
- Department of Ophthalmology and Hansen Experimental Physics Laboratory, Stanford University, Stanford, California 94305, USA
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18
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Bhuckory M, Wang BY, Chen ZC, Shin A, Pham-Howard D, Shah S, Monkongpitukkul N, Galambos L, Kamins T, Mathieson K, Palanker D. 3D electronic implants in subretinal space: long-term follow-up in rodents. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.07.25.550561. [PMID: 37546971 PMCID: PMC10402070 DOI: 10.1101/2023.07.25.550561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
Photovoltaic subretinal prosthesis (PRIMA) enables restoration of sight via electrical stimulation of the interneurons in degenerated retina, with resolution limited by the 100 μm pixel size. Since decreasing the pixel size below 75 μm in the current bipolar geometry is impossible, we explore the possibility of using smaller pixels based on a novel 3-dimensional honeycomb-shaped design. We assessed the long-term biocompatibility and stability of these arrays in rats by investigating the anatomical integration of the retina with flat and 3D implants and response to electrical stimulation over lifetime - up to 9 months post-implantation in aged rats. With both flat and 3D implants, VEP amplitude decreased after the day of implantation by more than 3-fold, and gradually recovered over about 3 months. With 25 µm high honeycomb walls, the majority of bipolar cells migrate into the wells, while amacrine and ganglion cells remain above the cavities, which is essential for selective network-mediated stimulation of the second-order neurons. Retinal thickness and full-field stimulation threshold with 40 µm-wide honeycomb pixels were comparable to those with planar devices - 0.05 mW/mm2 with 10ms pulses. However, fewer cells from the inner nuclear layer migrated into the 20 µm-wide wells, and stimulation threshold increased over 5 months, before stabilizing at about 0.08 mW/mm2. Such threshold is significantly lower than 1.8 mW/mm2 with a previous design of flat bipolar pixels, confirming the promise of the 3D honeycomb-based approach to high resolution subretinal prosthesis.
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Affiliation(s)
- Mohajeet Bhuckory
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, USA
- Department of Ophthalmology, Stanford University, Stanford, CA, USA
| | - Bing-Yi Wang
- Department of Physics, Stanford University, Stanford, CA, USA
| | - Zhijie Charles Chen
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
| | - Andrew Shin
- Department of Material Science, Stanford University, Stanford, CA, USA
| | - Davis Pham-Howard
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, USA
- Department of Ophthalmology, Stanford University, Stanford, CA, USA
| | - Sarthak Shah
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, USA
| | - Nicharee Monkongpitukkul
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, USA
- Department of Ophthalmology, Stanford University, Stanford, CA, USA
| | - Ludwig Galambos
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, USA
| | - Theodore Kamins
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, USA
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
| | - Keith Mathieson
- Department of Physics, Institute of Photonics, University of Strathclyde, Glasgow, Scotland, UK
| | - Daniel Palanker
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, USA
- Department of Ophthalmology, Stanford University, Stanford, CA, USA
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19
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Steins H, Mierzejewski M, Brauns L, Stumpf A, Kohler A, Heusel G, Corna A, Herrmann T, Jones PD, Zeck G, von Metzen R, Stieglitz T. A flexible protruding microelectrode array for neural interfacing in bioelectronic medicine. MICROSYSTEMS & NANOENGINEERING 2022; 8:131. [PMID: 36568135 PMCID: PMC9772315 DOI: 10.1038/s41378-022-00466-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 06/23/2022] [Accepted: 07/07/2022] [Indexed: 05/31/2023]
Abstract
Recording neural signals from delicate autonomic nerves is a challenging task that requires the development of a low-invasive neural interface with highly selective, micrometer-sized electrodes. This paper reports on the development of a three-dimensional (3D) protruding thin-film microelectrode array (MEA), which is intended to be used for recording low-amplitude neural signals from pelvic nervous structures by penetrating the nerves transversely to reduce the distance to the axons. Cylindrical gold pillars (Ø 20 or 50 µm, ~60 µm height) were fabricated on a micromachined polyimide substrate in an electroplating process. Their sidewalls were insulated with parylene C, and their tips were optionally modified by wet etching and/or the application of a titanium nitride (TiN) coating. The microelectrodes modified by these combined techniques exhibited low impedances (~7 kΩ at 1 kHz for Ø 50 µm microelectrode with the exposed surface area of ~5000 µm²) and low intrinsic noise levels. Their functionalities were evaluated in an ex vivo pilot study with mouse retinae, in which spontaneous neuronal spikes were recorded with amplitudes of up to 66 µV. This novel process strategy for fabricating flexible, 3D neural interfaces with low-impedance microelectrodes has the potential to selectively record neural signals from not only delicate structures such as retinal cells but also autonomic nerves with improved signal quality to study neural circuits and develop stimulation strategies in bioelectronic medicine, e.g., for the control of vital digestive functions.
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Affiliation(s)
- Helen Steins
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
- Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering, University of Freiburg, Freiburg, Germany
| | - Michael Mierzejewski
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Lisa Brauns
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Angelika Stumpf
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Alina Kohler
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Gerhard Heusel
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Andrea Corna
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
- Institute of Biomedical Electronics, TU Wien, Vienna, Austria
| | - Thoralf Herrmann
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Peter D. Jones
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Günther Zeck
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
- Institute of Biomedical Electronics, TU Wien, Vienna, Austria
| | - Rene von Metzen
- NMI Natural and Medical Sciences Institute at the University of Tübingen, Reutlingen, Germany
| | - Thomas Stieglitz
- Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering, University of Freiburg, Freiburg, Germany
- Bernstein Center Freiburg, University of Freiburg, Freiburg, Germany
- BrainLinks-BrainTools, University of Freiburg, Freiburg, Germany
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20
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Wang BY, Chen ZC, Bhuckory M, Huang T, Shin A, Zuckerman V, Ho E, Rosenfeld E, Galambos L, Kamins T, Mathieson K, Palanker D. Electronic photoreceptors enable prosthetic visual acuity matching the natural resolution in rats. Nat Commun 2022; 13:6627. [PMID: 36333326 PMCID: PMC9636145 DOI: 10.1038/s41467-022-34353-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022] Open
Abstract
Localized stimulation of the inner retinal neurons for high-acuity prosthetic vision requires small pixels and minimal crosstalk from the neighboring electrodes. Local return electrodes within each pixel limit the crosstalk, but they over-constrain the electric field, thus precluding the efficient stimulation with subretinal pixels smaller than 55 μm. Here we demonstrate a high-resolution prosthetic vision based on a novel design of a photovoltaic array, where field confinement is achieved dynamically, leveraging the adjustable conductivity of the diodes under forward bias to turn the designated pixels into transient returns. We validated the computational modeling of the field confinement in such an optically-controlled circuit by in-vitro and in-vivo measurements. Most importantly, using this strategy, we demonstrated that the grating acuity with 40 μm pixels matches the pixel pitch, while with 20 μm pixels, it reaches the 28 μm limit of the natural visual resolution in rats. This method enables customized field shaping based on individual retinal thickness and distance from the implant, paving the way to higher acuity of prosthetic vision in atrophic macular degeneration.
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Affiliation(s)
- Bing-Yi Wang
- Department of Physics, Stanford University, Stanford, CA, USA.
| | - Zhijie Charles Chen
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA.
| | - Mohajeet Bhuckory
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, USA
- Department of Ophthalmology, Stanford University, Stanford, CA, USA
| | - Tiffany Huang
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
| | - Andrew Shin
- Department of Material Science, Stanford University, Stanford, CA, USA
| | - Valentina Zuckerman
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, USA
| | - Elton Ho
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, USA
- Department of Ophthalmology, Stanford University, Stanford, CA, USA
| | - Ethan Rosenfeld
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, USA
| | - Ludwig Galambos
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
| | - Theodore Kamins
- Department of Electrical Engineering, Stanford University, Stanford, CA, USA
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, USA
| | - Keith Mathieson
- Department of Physics, Institute of Photonics, University of Strathclyde, Glasgow, Scotland, UK
| | - Daniel Palanker
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, USA
- Department of Ophthalmology, Stanford University, Stanford, CA, USA
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21
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Vu QA, Seo HW, Choi KE, Kim N, Kang YN, Lee J, Park SH, Kim JT, Kim S, Kim SW. Structural changes in the retina after implantation of subretinal three-dimensional implants in mini pigs. Front Neurosci 2022; 16:1010445. [PMID: 36248640 PMCID: PMC9561346 DOI: 10.3389/fnins.2022.1010445] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 09/16/2022] [Indexed: 11/30/2022] Open
Abstract
The retinal structural changes after subretinal implantation of three-dimensional (3D) microelectrodes were investigated in a mini pig. Three types of electrode were implanted into the subretinal spaces of nine mini pigs: 75-μm-high 3D electrodes on a 200-μm-thick right-angled polydimethylsiloxane (PDMS) substrate (group 1); a 140-μm-thick sloped PDMS substrate without electrodes (group 2); and a 140-μm-thick sloped PDMS substrate with 20-μm-high 3D electrodes (group 3). One mini pig was used as a control. Spectral domain–optical coherence tomography (SD–OCT) images were obtained at baseline and 2, 6, and 12 weeks post-surgery. Retinal specimens were immunostained using a tissue-clearing method 3 months post-implantation. The 75-μm-high 3D electrodes progressively penetrated the inner nuclear layer (INL) and touched the inner plexiform layer (IPL) 2 weeks post-surgery. At 6 weeks post-operatively, the electrodes were in contact with the nerve-fiber layer, accompanied by a severe fibrous reaction. In the other groups, the implants remained in place without subretinal migration. Immunostaining showed that retinal ganglion and bipolar cells were preserved without fibrosis over the retinal implants in groups 2 and 3 during the 12-week implantation period. In summary, SD–OCT and immunohistology results showed differences in the extent of reactions, such as fibrosis over the implants and penetration of the electrodes into the inner retinal layer depending on different types of electrodes. A sloped substrate performed better than a right-angled substrate in terms of retinal preservation over the implanted electrodes. The 20-μm-high electrodes showed better structural compatibility than the 75-μm-high 3D electrodes. There was no significant difference between the results of sloped implants without electrodes and 20-μm-high 3D electrodes, indicating that the latter had no adverse effects on retinal tissue.
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Affiliation(s)
- Que Anh Vu
- Department of Ophthalmology, Korea University School of Medicine, Seoul, South Korea
- Department of Ophthalmology, Hanoi Medical University, Hanoi, Vietnam
| | - Hee Won Seo
- Department of Robotics and Mechatronics Engineering, Daegu Gyeongbuk Institute of Science and Technology (DGIST), Daegu, South Korea
| | - Kwang-Eon Choi
- Department of Ophthalmology, Korea University School of Medicine, Seoul, South Korea
| | - Namju Kim
- Department of Robotics and Mechatronics Engineering, Daegu Gyeongbuk Institute of Science and Technology (DGIST), Daegu, South Korea
| | - Yoo Na Kang
- Department of Medical Assistant Robot, Korea Institute of Machinery and Materials (KIMM), Daegu, South Korea
| | - Jaemeun Lee
- R&D Center for Advanced Pharmaceuticals and Evaluation, Korea Institute of Toxicology, Daejeon, South Korea
| | - Sun-Hyun Park
- R&D Center for Advanced Pharmaceuticals and Evaluation, Korea Institute of Toxicology, Daejeon, South Korea
| | - Jee Taek Kim
- Department of Ophthalmology, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Sohee Kim
- Department of Robotics and Mechatronics Engineering, Daegu Gyeongbuk Institute of Science and Technology (DGIST), Daegu, South Korea
- *Correspondence: Sohee Kim,
| | - Seong-Woo Kim
- Department of Ophthalmology, Korea University School of Medicine, Seoul, South Korea
- Seong-Woo Kim,
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22
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Chen ZC, Wang BY, Goldstein AK, Butt E, Mathieson K, Palanker D. Photovoltaic implant simulator reveals resolution limits in subretinal prosthesis. J Neural Eng 2022; 19:10.1088/1741-2552/ac8ed8. [PMID: 36055219 PMCID: PMC10752425 DOI: 10.1088/1741-2552/ac8ed8] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 09/02/2022] [Indexed: 11/11/2022]
Abstract
Objective.PRIMA, the photovoltaic subretinal prosthesis, restores central vision in patients blinded by atrophic age-related macular degeneration (AMD), with a resolution closely matching the 100µm pixel size of the implant. Improvement in resolution requires smaller pixels, but the resultant electric field may not provide sufficient stimulation strength in the inner nuclear layer (INL) or may lead to excessive crosstalk between neighboring electrodes, resulting in low contrast stimulation patterns. We study the approaches to electric field shaping in the retina for prosthetic vision with higher resolution and improved contrast.Approach.We present a new computational framework, Retinal Prosthesis Simulator (RPSim), that efficiently computes the electric field in the retina generated by a photovoltaic implant with thousands of electrodes. Leveraging the PRIMA clinical results as a benchmark, we use RPSim to predict the stimulus strength and contrast of the electric field in the retina with various pixel designs and stimulation patterns.Main results.We demonstrate that by utilizing monopolar pixels as both anodes and cathodes to suppress crosstalk, most patients may achieve resolution no worse than 48µm. Closer proximity between the electrodes and the INL, achieved with pillar electrodes, enhances the stimulus strength and contrast and may enable 24µm resolution with 20µm pixels, at least in some patients.Significance.A resolution of 24µm on the retina corresponds to a visual acuity of 20/100, which is over 4 times higher than the current best prosthetic acuity of 20/438, promising a significant improvement of central vision for many AMD patients.
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Affiliation(s)
- Zhijie Charles Chen
- Department of Electrical Engineering, Stanford University, Stanford, CA, United States of America
| | - Bing-Yi Wang
- Department of Physics, Stanford University, Stanford, CA, United States of America
| | - Anna Kochnev Goldstein
- Department of Electrical Engineering, Stanford University, Stanford, CA, United States of America
| | - Emma Butt
- Institute of Photonics, Department of Physics, University of Strathclyde, Glasgow, United Kingdom
| | - Keith Mathieson
- Institute of Photonics, Department of Physics, University of Strathclyde, Glasgow, United Kingdom
| | - Daniel Palanker
- Department of Ophthalmology, Stanford University, Stanford, CA, United States of America
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, United States of America
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23
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Wang BY, Chen ZC, Bhuckory M, Kochnev Goldstein A, Palanker D. Pixel size limit of the PRIMA implants: from humans to rodents and back. J Neural Eng 2022; 19:10.1088/1741-2552/ac8e31. [PMID: 36044878 PMCID: PMC9527086 DOI: 10.1088/1741-2552/ac8e31] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/31/2022] [Indexed: 11/11/2022]
Abstract
Objective.Retinal prostheses aim at restoring sight in patients with retinal degeneration by electrically stimulating the inner retinal neurons. Clinical trials with patients blinded by atrophic age-related macular degeneration using the PRIMA subretinal implant, a 2 × 2 mm array of 100µm-wide photovoltaic pixels, have demonstrated a prosthetic visual acuity closely matching the pixel size. Further improvement in resolution requires smaller pixels, which, with the current bipolar design, necessitates more intense stimulation.Approach.We examine the lower limit of the pixel size for PRIMA implants by modeling the electric field, leveraging the clinical benchmarks, and using animal data to assess the stimulation strength and contrast of various patterns. Visually evoked potentials measured in Royal College of Surgeons rats with photovoltaic implants composed of 100µm and 75µm pixels were compared to clinical thresholds with 100µm pixels. Electrical stimulation model calibrated by the clinical and rodent data was used to predict the performance of the implant with smaller pixels.Main results.PRIMA implants with 75µm bipolar pixels under the maximum safe near-infrared (880 nm) illumination of 8 mW mm-2with 30% duty cycle (10 ms pulses at 30 Hz) should provide a similar perceptual brightness as with 100µm pixels under 3 mW mm-2irradiance, used in the current clinical trials. Contrast of the Landolt C pattern scaled down to 75µm pixels is also similar under such illumination to that with 100µm pixels, increasing the maximum acuity from 20/420 to 20/315.Significance.Computational modeling defines the minimum pixel size of the PRIMA implants as 75µm. Increasing the implant width from 2 to 3 mm and reducing the pixel size from 100 to 75µm will nearly quadrupole the number of pixels, which should be very beneficial for patients. Smaller pixels of the same bipolar flat geometry would require excessively intense illumination, and therefore a different pixel design should be considered for further improvement in resolution.
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Affiliation(s)
- Bing-Yi Wang
- Department of Physics, Stanford University, Stanford, CA, United States of America
| | - Zhijie Charles Chen
- Department of Electrical Engineering, Stanford University, Stanford, CA, United States of America
| | - Mohajeet Bhuckory
- Department of Ophthalmology, Stanford University, Stanford, CA, United States of America
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, United States of America
| | - Anna Kochnev Goldstein
- Department of Electrical Engineering, Stanford University, Stanford, CA, United States of America
| | - Daniel Palanker
- Department of Ophthalmology, Stanford University, Stanford, CA, United States of America
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, United States of America
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24
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Lee SW, Fried SI. Micro-magnetic stimulation of primary visual cortex induces focal and sustained activation of secondary visual cortex. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2022; 380:20210019. [PMID: 35658677 DOI: 10.1098/rsta.2021.0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 10/01/2021] [Indexed: 06/15/2023]
Abstract
Cortical visual prostheses that aim to restore sight to the blind require the ability to create neural activity in the visual cortex. Electric stimulation delivered via microelectrodes implanted in the primary visual cortex (V1) has been the most common approach, although conventional electrodes may not effectively confine activation to focal regions and thus the acuity they create may be limited. Magnetic stimulation from microcoils confines activation to single cortical columns of V1 and thus may prove to be more effective than conventional microelectrodes, but the ability of microcoils to drive synaptic connections has not been explored. Here, we show that magnetic stimulation of V1 using microcoils induces spatially confined activation in the secondary visual cortex (V2) in mouse brain slices. Single-loop microcoils were fabricated using platinum-iridium flat microwires, and their effectiveness was evaluated using calcium imaging and compared with that of monopolar and bipolar electrodes. Our results show that compared to the electrodes, the microcoils better confined activation to a small region in V1. In addition, they produced more precise and sustained activation in V2. The finding that microcoil-based stimulation propagates to higher visual centres raises the possibility that complex visual perception, e.g. that requiring sustained synaptic inputs, may be achievable. This article is part of the theme issue 'Advanced neurotechnologies: translating innovation for health and well-being'.
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Affiliation(s)
- Seung Woo Lee
- Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Shelley I Fried
- Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Boston VA Healthcare System, Boston, MA, USA
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25
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Cha S, Ahn J, Jeong Y, Lee YH, Kim HK, Lee D, Yoo Y, Goo YS. Stage-Dependent Changes of Visual Function and Electrical Response of the Retina in the rd10 Mouse Model. Front Cell Neurosci 2022; 16:926096. [PMID: 35936494 PMCID: PMC9345760 DOI: 10.3389/fncel.2022.926096] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 06/23/2022] [Indexed: 12/28/2022] Open
Abstract
One of the critical prerequisites for the successful development of retinal prostheses is understanding the physiological features of retinal ganglion cells (RGCs) in the different stages of retinal degeneration (RD). This study used our custom-made rd10 mice, C57BL/6-Pde6bem1(R560C)Dkl/Korl mutated on the Pde6b gene in C57BL/6J mouse with the CRISPR/Cas9-based gene-editing method. We selected the postnatal day (P) 45, P70, P140, and P238 as representative ages for RD stages. The optomotor response measured the visual acuity across degeneration stages. At P45, the rd10 mice exhibited lower visual acuity than wild-type (WT) mice. At P140 and older, no optomotor response was observed. We classified RGC responses to the flashed light into ON, OFF, and ON/OFF RGCs via in vitro multichannel recording. With degeneration, the number of RGCs responding to the light stimulation decreased in all three types of RGCs. The OFF response disappeared faster than the ON response with older postnatal ages. We elicited RGC spikes with electrical stimulation and analyzed the network-mediated RGC response in the rd10 mice. Across all postnatal ages, the spikes of rd10 RGCs were less elicited by pulse amplitude modulation than in WT RGCs. The ratio of RGCs showing multiple peaks of spike burst increased in older ages. The electrically evoked RGC spikes by the pulse amplitude modulation differ across postnatal ages. Therefore, degeneration stage-dependent stimulation strategies should be considered for developing retinal prosthesis and successful vision restoration.
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Affiliation(s)
- Seongkwang Cha
- Department of Physiology, Chungbuk National University School of Medicine, Cheongju, South Korea
| | - Jungryul Ahn
- Department of Physiology, Chungbuk National University School of Medicine, Cheongju, South Korea
| | - Yurim Jeong
- Department of Physiology, Chungbuk National University School of Medicine, Cheongju, South Korea
| | - Yong Hee Lee
- Department of Biochemistry, Chungbuk National University School of Medicine, Cheongju, South Korea
| | - Hyong Kyu Kim
- Department of Microbiology, Chungbuk National University School of Medicine, Cheongju, South Korea
| | - Daekee Lee
- Department of Life Science, Ewha Womans University, Seoul, South Korea
| | - Yongseok Yoo
- Department of Electronics Engineering, Incheon National University, Incheon, South Korea
- *Correspondence: Yongseok Yoo,
| | - Yong Sook Goo
- Department of Physiology, Chungbuk National University School of Medicine, Cheongju, South Korea
- Yong Sook Goo,
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26
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Tringides CM, Mooney DJ. Materials for Implantable Surface Electrode Arrays: Current Status and Future Directions. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2022; 34:e2107207. [PMID: 34716730 DOI: 10.1002/adma.202107207] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 10/26/2021] [Indexed: 06/13/2023]
Abstract
Surface electrode arrays are mainly fabricated from rigid or elastic materials, and precisely manipulated ductile metal films, which offer limited stretchability. However, the living tissues to which they are applied are nonlinear viscoelastic materials, which can undergo significant mechanical deformation in dynamic biological environments. Further, the same arrays and compositions are often repurposed for vastly different tissues rather than optimizing the materials and mechanical properties of the implant for the target application. By first characterizing the desired biological environment, and then designing a technology for a particular organ, surface electrode arrays may be more conformable, and offer better interfaces to tissues while causing less damage. Here, the various materials used in each component of a surface electrode array are first reviewed, and then electrically active implants in three specific biological systems, the nervous system, the muscular system, and skin, are described. Finally, the fabrication of next-generation surface arrays that overcome current limitations is discussed.
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Affiliation(s)
- Christina M Tringides
- Harvard Program in Biophysics, Harvard University, Cambridge, MA, 02138, USA
- Harvard-MIT Division in Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Cambridge, MA, 02138, USA
| | - David J Mooney
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Cambridge, MA, 02138, USA
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, 02138, USA
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27
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Selective Passivation of Three-Dimensional Carbon Microelectrodes by Polydopamine Electrodeposition and Local Laser Ablation. MICROMACHINES 2022; 13:mi13030371. [PMID: 35334663 PMCID: PMC8950879 DOI: 10.3390/mi13030371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 02/04/2023]
Abstract
In this article, a novel approach for selective passivation of three-dimensional pyrolytic carbon microelectrodes via a facile electrochemical polymerization of a non-conductive polymer (polydopamine, PDA) onto the surface of carbon electrodes, followed by a selective laser ablation is elaborated. The 3D carbon electrodes consisting of 284 micropillars on a circular 2D carbon base layer were fabricated by pyrolysis of lithographically patterned negative photoresist SU-8. As a second step, dopamine was electropolymerized onto the electrode by cyclic voltammetry (CV) to provide an insulating layer at its surface. The CV parameters, such as the scan rate and the number of cycles, were investigated and optimized to achieve a reliable and uniform non-conductive coating on the surface of the 3D pyrolytic carbon electrode. Finally, the polydopamine was selectively removed only from the tips of the pillars, by using localized laser ablation. The selectively passivated electrodes were characterized by scanning electron microscopy, cyclic voltammetry and electrochemical impedance spectroscopy methods. Due to the surface being composed of highly biocompatible materials, such as pyrolytic carbon and polydopamine, these 3D electrodes are particularly suited for biological application, such as electrochemical monitoring of cells or retinal implants, where highly localized electrical stimulation of nerve cells is beneficial.
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28
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Palanker D, Le Mer Y, Mohand-Said S, Sahel JA. Simultaneous perception of prosthetic and natural vision in AMD patients. Nat Commun 2022; 13:513. [PMID: 35082313 PMCID: PMC8792035 DOI: 10.1038/s41467-022-28125-x] [Citation(s) in RCA: 48] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 01/11/2022] [Indexed: 11/26/2022] Open
Abstract
Loss of photoreceptors in atrophic age-related macular degeneration (AMD) results in severe visual impairment. Since the low-resolution peripheral vision is retained in such conditions, restoration of central vision should not jeopardize the surrounding healthy retina and allow for simultaneous use of the natural and prosthetic sight. This interim report, prespecified in the study protocol, presents the first clinical results with a photovoltaic substitute of the photoreceptors providing simultaneous use of the central prosthetic and peripheral natural vision in atrophic AMD. In this open-label single group feasibility trial (NCT03333954, recruitment completed), five patients with geographic atrophy have been implanted with a wireless 2 x 2 mm-wide 30 µm-thick device, having 378 pixels of 100 µm in size. All 5 patients achieved the primary outcome of the study by demonstrating the prosthetic visual perception in the former scotoma. The four patients with a subretinal placement of the chip demonstrated the secondary outcome: Landolt acuity of 1.17 ± 0.13 pixels, corresponding to the Snellen range of 20/460-20/565. With electronic magnification of up to a factor of 8, patients demonstrated prosthetic acuity in the range of 20/63-20/98. Under room lighting conditions, patients could simultaneously use prosthetic central vision and their remaining peripheral vision in the implanted eye and in the fellow eye.
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Affiliation(s)
- D Palanker
- Department of Ophthalmology and Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, USA.
| | - Y Le Mer
- Department of Ophthalmology, Fondation Ophtalmologique A. de Rothschild, Paris, France
| | - S Mohand-Said
- Clinical Investigation Center INSERM-DGOS 1423, Quinze-Vingts National Eye Hospital, Paris, France
| | - J A Sahel
- Department of Ophthalmology, Fondation Ophtalmologique A. de Rothschild, Paris, France
- Clinical Investigation Center INSERM-DGOS 1423, Quinze-Vingts National Eye Hospital, Paris, France
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
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29
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Benfenati F, Lanzani G. Reply to: Questions about the role of P3HT nanoparticles in retinal stimulation. NATURE NANOTECHNOLOGY 2021; 16:1333-1336. [PMID: 34887531 DOI: 10.1038/s41565-021-01043-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 10/19/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Fabio Benfenati
- Center for Synaptic Neuroscience and Technology, Istituto Italiano di Tecnologia, Genova, Italy.
- IRCCS Ospedale Policlinico San Martino, Genova, Italy.
| | - Guglielmo Lanzani
- Center for Nanoscience and Technology, Istituto Italiano di Tecnologia, Milan, Italy
- Department of Physics, Politecnico di Milano, Milan, Italy
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30
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Palanker D, Głowacki ED, Ghezzi D. Questions about the role of P3HT nanoparticles in retinal stimulation. NATURE NANOTECHNOLOGY 2021; 16:1330-1332. [PMID: 34887532 PMCID: PMC10789482 DOI: 10.1038/s41565-021-01044-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 10/19/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Daniel Palanker
- Department of Ophthalmology and Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA, USA.
| | - Eric Daniel Głowacki
- Bioelectronics Materials and Devices Laboratory, Central European Institute of Technology, Brno University of Technology, Brno, Czech Republic
| | - Diego Ghezzi
- Medtronic Chair in Neuroengineering, Center for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École polytechnique fédérale de Lausanne, Geneva, Switzerland
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31
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Cho YH, Park YG, Kim S, Park JU. 3D Electrodes for Bioelectronics. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2021; 33:e2005805. [PMID: 34013548 DOI: 10.1002/adma.202005805] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 10/04/2020] [Indexed: 05/08/2023]
Abstract
In recent studies related to bioelectronics, significant efforts have been made to form 3D electrodes to increase the effective surface area or to optimize the transfer of signals at tissue-electrode interfaces. Although bioelectronic devices with 2D and flat electrode structures have been used extensively for monitoring biological signals, these 2D planar electrodes have made it difficult to form biocompatible and uniform interfaces with nonplanar and soft biological systems (at the cellular or tissue levels). Especially, recent biomedical applications have been expanding rapidly toward 3D organoids and the deep tissues of living animals, and 3D bioelectrodes are getting significant attention because they can reach the deep regions of various 3D tissues. An overview of recent studies on 3D bioelectronic devices, such as the use of electrical stimulations and the recording of neural signals from biological subjects, is presented. Subsequently, the recent developments in materials and fabrication processing to 3D micro- and nanostructures are introduced, followed by broad applications of these 3D bioelectronic devices at various in vitro and in vivo conditions.
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Affiliation(s)
- Yo Han Cho
- Nano Science Technology Institute, Department of Materials Science and Engineering, Yonsei University, Seoul, 03722, Republic of Korea
- Center for Nanomedicine, Institute for Basic Science (IBS), Seoul, 03722, Republic of Korea
- Graduate Program of Nano Biomedical Engineering (NanoBME), Advanced Science Institute, Yonsei University, Seoul, 03722, Republic of Korea
| | - Young-Geun Park
- Nano Science Technology Institute, Department of Materials Science and Engineering, Yonsei University, Seoul, 03722, Republic of Korea
- Center for Nanomedicine, Institute for Basic Science (IBS), Seoul, 03722, Republic of Korea
- Graduate Program of Nano Biomedical Engineering (NanoBME), Advanced Science Institute, Yonsei University, Seoul, 03722, Republic of Korea
| | - Sumin Kim
- Nano Science Technology Institute, Department of Materials Science and Engineering, Yonsei University, Seoul, 03722, Republic of Korea
- Center for Nanomedicine, Institute for Basic Science (IBS), Seoul, 03722, Republic of Korea
- Graduate Program of Nano Biomedical Engineering (NanoBME), Advanced Science Institute, Yonsei University, Seoul, 03722, Republic of Korea
| | - Jang-Ung Park
- Nano Science Technology Institute, Department of Materials Science and Engineering, Yonsei University, Seoul, 03722, Republic of Korea
- Center for Nanomedicine, Institute for Basic Science (IBS), Seoul, 03722, Republic of Korea
- Graduate Program of Nano Biomedical Engineering (NanoBME), Advanced Science Institute, Yonsei University, Seoul, 03722, Republic of Korea
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32
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Damle S, Carleton M, Kapogianis T, Arya S, Cavichini-Corderio M, Freeman WR, Lo YH, Oesch NW. Minimizing Iridium Oxide Electrodes for High Visual Acuity Subretinal Stimulation. eNeuro 2021; 8:ENEURO.0506-20.2021. [PMID: 34799411 PMCID: PMC8704424 DOI: 10.1523/eneuro.0506-20.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 10/28/2021] [Accepted: 11/15/2021] [Indexed: 11/21/2022] Open
Abstract
Vision loss from diseases of the outer retina, such as age-related macular degeneration, is among the leading causes of irreversible blindness in the world today. The goal of retinal prosthetics is to replace the photo-sensing function of photoreceptors lost in these diseases with optoelectronic hardware to electrically stimulate patterns of retinal activity corresponding to vision. To enable high-resolution retinal prosthetics, the scale of stimulating electrodes must be significantly decreased from current designs; however, this reduces the amount of stimulating current that can be delivered. The efficacy of subretinal stimulation at electrode sizes suitable for high visual acuity retinal prosthesis are not well understood, particularly within the safe charge injection limits of electrode materials. Here, we measure retinal ganglion cell (RGC) responses in a mouse model of blindness to evaluate the stimulation efficacy of 10, 20, and 30 μm diameter iridium oxide electrodes within the electrode charge injection limits, focusing on measures of charge threshold and dynamic range. Stimulation thresholds were lower for smaller electrodes, but larger electrodes could elicit a greater dynamic range of spikes and recruited more ganglion cells within charge injection limits. These findings suggest a practical lower limit for planar electrode size and indicate strategies for maximizing stimulation thresholds and dynamic range.
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Affiliation(s)
- Samir Damle
- Department of Bioengineering, University of California San Diego, La Jolla, CA 92093
| | - Maya Carleton
- Department of Psychology, University of California San Diego, La Jolla, CA 92093
| | - Theodoros Kapogianis
- Department of Psychology, University of California San Diego, La Jolla, CA 92093
| | - Shaurya Arya
- Department of Electrical and Computer Engineering, University of California San Diego, La Jolla, CA 92161
| | - Melina Cavichini-Corderio
- Jacobs Retina Center at Shiley Eye Institute, Department of Ophthalmology, University of California San Diego, La Jolla, CA 92093
| | - William R Freeman
- Jacobs Retina Center at Shiley Eye Institute, Department of Ophthalmology, University of California San Diego, La Jolla, CA 92093
| | - Yu-Hwa Lo
- Department of Electrical and Computer Engineering, University of California San Diego, La Jolla, CA 92161
| | - Nicholas W Oesch
- Department of Psychology, University of California San Diego, La Jolla, CA 92093
- Jacobs Retina Center at Shiley Eye Institute, Department of Ophthalmology, University of California San Diego, La Jolla, CA 92093
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33
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Ambient Light Rejection Integrated Circuit for Autonomous Adaptation on a Sub-Retinal Prosthetic System. SENSORS 2021; 21:s21165638. [PMID: 34451078 PMCID: PMC8402464 DOI: 10.3390/s21165638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/18/2021] [Accepted: 08/19/2021] [Indexed: 11/17/2022]
Abstract
This paper introduces an ambient light rejection (ALR) circuit for the autonomous adaptation of a subretinal implant system. The sub-retinal implants, located beneath a bipolar cell layer, are known to have a significant advantage in spatial resolution by integrating more than a thousand pixels, compared to epi-retinal implants. However, challenges remain regarding current dispersion in high-density retinal implants, and ambient light induces pixel saturation. Thus, the technical issues of ambient light associated with a conventional image processing technique, which lead to high power consumption and area occupation, are still unresolved. Thus, it is necessary to develop a novel image-processing unit to handle ambient light, considering constraints related to power and area. In this paper, we present an ALR circuit as an image-processing unit for sub-retinal implants. We first introduced an ALR algorithm to reduce the ambient light in conventional retinal implants; next, we implemented the ALR algorithm as an application-specific integrated chip (ASIC). The ALR circuit was fabricated using a standard 0.35-μm CMOS process along with an image-sensor-based stimulator, a sensor pixel, and digital blocks. As experimental results, the ALR circuit occupies an area of 190 µm2, consumes a power of 3.2 mW and shows a maximum response time of 1.6 s at a light intensity of 20,000 lux. The proposed ALR circuit also has a pixel loss rate of 0.3%. The experimental results show that the ALR circuit leads to a sensor pixel (SP) being autonomously adjusted, depending on the light intensity.
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34
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Corna A, Ramesh P, Jetter F, Lee MJ, Macke JH, Zeck G. Discrimination of simple objects decoded from the output of retinal ganglion cells upon sinusoidal electrical stimulation. J Neural Eng 2021; 18. [PMID: 34049288 DOI: 10.1088/1741-2552/ac0679] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 05/28/2021] [Indexed: 11/12/2022]
Abstract
Objective. Most neuroprosthetic implants employ pulsatile square-wave electrical stimuli, which are significantly different from physiological inter-neuronal communication. In case of retinal neuroprosthetics, which use a certain type of pulsatile stimuli, reliable object and contrast discrimination by implanted blind patients remained challenging. Here we investigated to what extent simple objects can be discriminated from the output of retinal ganglion cells (RGCs) upon sinusoidal stimulation.Approach. Spatially confined objects were formed by different combinations of 1024 stimulating microelectrodes. The RGC activity in theex vivoretina of photoreceptor-degenerated mouse, of healthy mouse or of primate was recorded simultaneously using an interleaved recording microelectrode array implemented in a CMOS-based chip.Main results. We report that application of sinusoidal electrical stimuli (40 Hz) in epiretinal configuration instantaneously and reliably modulates the RGC activity in spatially confined areas at low stimulation threshold charge densities (40 nC mm-2). Classification of overlapping but spatially displaced objects (1° separation) was achieved by distinct spiking activity of selected RGCs. A classifier (regularized logistic regression) discriminated spatially displaced objects (size: 5.5° or 3.5°) with high accuracy (90% or 62%). Stimulation with low artificial contrast (10%) encoded by different stimulus amplitudes generated RGC activity, which was classified with an accuracy of 80% for large objects (5.5°).Significance. We conclude that time-continuous smooth-wave stimulation provides robust, localized neuronal activation in photoreceptor-degenerated retina, which may enable future artificial vision at high temporal, spatial and contrast resolution.
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Affiliation(s)
- Andrea Corna
- Neurophysics, NMI Natural and Medical Sciences Institute at the University Tübingen, Reutlingen, Germany.,Institute for Ophthalmic Research, University of Tübingen, Tübingen, Germany.,Graduate School of Neural Information Processing/International Max Planck Research School, Tübingen, Germany.,Biomedical Electronics and Systems, EMCE Institute, TU Wien, Wien, Austria
| | - Poornima Ramesh
- Computational Neuroengineering, Technical University München, München, Germany.,Machine Learning in Science, University of Tübingen, Tübingen, Germany
| | - Florian Jetter
- Neurophysics, NMI Natural and Medical Sciences Institute at the University Tübingen, Reutlingen, Germany.,Graduate School of Neural Information Processing/International Max Planck Research School, Tübingen, Germany
| | - Meng-Jung Lee
- Neurophysics, NMI Natural and Medical Sciences Institute at the University Tübingen, Reutlingen, Germany.,Graduate School of Neural Information Processing/International Max Planck Research School, Tübingen, Germany
| | - Jakob H Macke
- Computational Neuroengineering, Technical University München, München, Germany.,Machine Learning in Science, University of Tübingen, Tübingen, Germany.,MPI for Intelligent Systems, Tübingen, Germany
| | - Günther Zeck
- Neurophysics, NMI Natural and Medical Sciences Institute at the University Tübingen, Reutlingen, Germany.,Biomedical Electronics and Systems, EMCE Institute, TU Wien, Wien, Austria
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35
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Moleirinho S, Whalen AJ, Fried SI, Pezaris JS. The impact of synchronous versus asynchronous electrical stimulation in artificial vision. J Neural Eng 2021; 18. [PMID: 33900206 DOI: 10.1088/1741-2552/abecf1] [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: 08/22/2020] [Accepted: 03/09/2021] [Indexed: 11/12/2022]
Abstract
Visual prosthesis devices designed to restore sight to the blind have been under development in the laboratory for several decades. Clinical translation continues to be challenging, due in part to gaps in our understanding of critical parameters such as how phosphenes, the electrically-generated pixels of artificial vision, can be combined to form images. In this review we explore the effects that synchronous and asynchronous electrical stimulation across multiple electrodes have in evoking phosphenes. Understanding how electrical patterns influence phosphene generation to control object binding and perception of visual form is fundamental to creation of a clinically successful prosthesis.
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Affiliation(s)
- Susana Moleirinho
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, United States of America.,Department of Neurosurgery, Harvard Medical School, Boston, MA, United States of America
| | - Andrew J Whalen
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, United States of America.,Department of Neurosurgery, Harvard Medical School, Boston, MA, United States of America
| | - Shelley I Fried
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, United States of America.,Department of Neurosurgery, Harvard Medical School, Boston, MA, United States of America.,Boston VA Healthcare System, Boston, MA, United States of America
| | - John S Pezaris
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, United States of America.,Department of Neurosurgery, Harvard Medical School, Boston, MA, United States of America
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36
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Huang TW, Kamins T, Chen ZC, Wang BY, Bhuckory M, Galambos L, Ho E, Ling T, Afshar S, Shin A, Zuckerman V, Harris JS, Mathieson K, Palanker D. Vertical-junction photodiodes for smaller pixels in retinal prostheses. J Neural Eng 2021; 18. [PMID: 33592588 DOI: 10.1088/1741-2552/abe6b8] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/16/2021] [Indexed: 01/27/2023]
Abstract
Objective.To restore central vision in patients with atrophic age-related macular degeneration, we replace the lost photoreceptors with photovoltaic pixels, which convert light into current and stimulate the secondary retinal neurons. Clinical trials demonstrated prosthetic acuity closely matching the sampling limit of the 100 μm pixels, and hence smaller pixels are required for improving visual acuity. However, with smaller flat bipolar pixels, the electric field penetration depth and the photodiode responsivity significantly decrease, making the device inefficient. Smaller pixels may be enabled by (1) increasing the diode responsivity using vertical p-n junctions and (2) directing the electric field in tissue vertically. Here, we demonstrate such novel photodiodes and test the retinal stimulation in a vertical electric field.Approach.Arrays of silicon photodiodes of 55, 40, 30, and 20 μm in width, with vertical p-n junctions, were fabricated. The electric field in the retina was directed vertically using a common return electrode at the edge of the devices. Optical and electronic performance of the diodes was characterized in-vitro, and retinal stimulation threshold measured by recording the visually evoked potentials (VEPs) in rats with retinal degeneration.Main results.The photodiodes exhibited sufficiently low dark current (<10 pA) and responsivity at 880 nm wavelength as high as 0.51 A/W, with 85% internal quantum efficiency, independent of pixel size. Field mapping in saline demonstrated uniformity of the pixel performance in the array. The full-field stimulation threshold was as low as 0.057±0.029 mW/mm2with 10 ms pulses, independent of pixel size.Significance.Photodiodes with vertical p-n junctions demonstrated excellent charge collection efficiency independent of pixel size, down to 20 μm. Vertically-oriented electric field provides a stimulation threshold that is independent of pixel size. These results are the first steps in validation of scaling down the photovoltaic pixels for subretinal stimulation.
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Affiliation(s)
- Tiffany W Huang
- Electrical Engineering, Stanford University, 450 Serra Mall, Stanford, California, 94305, UNITED STATES
| | - Theodore Kamins
- Electrical Engineering, Stanford University, 450 Serra Mall, Stanford, California, 94305, UNITED STATES
| | - Zhijie Charles Chen
- Electrical Engineering, Stanford University, 452 Lomita Mall, Rm 136, Stanford, California, 94305-6104, UNITED STATES
| | - Bing-Yi Wang
- Physics, Stanford University, 450 Serra Mall, Stanford, 94305, UNITED STATES
| | - Mohajeet Bhuckory
- Ophthalmology, Stanford University, 450 Serra Mall, Stanford, California, 94305, UNITED STATES
| | - Ludwig Galambos
- Electrical Engineering, Stanford University, 450 Serra Mall, Stanford, California, 94305, UNITED STATES
| | - Elton Ho
- Physics, Stanford University, 452 Lomita Mall, Stanford, California, 94305, UNITED STATES
| | - Tong Ling
- Ophthalmology, Hansen Experimental Physics Laboratory, Stanford University, 450 Serra Mall, Stanford, California, 94305, UNITED STATES
| | - Sean Afshar
- Electrical Engineering, Stanford University, 450 Serra Mall, Stanford, California, 94305-6104, UNITED STATES
| | - Andrew Shin
- Materials Science and Engineering, Stanford University, 420 Via Palou Mall, Stanford, California, 94305, UNITED STATES
| | - Valentina Zuckerman
- Hansen Experimental Physics Laboratory, Stanford University, 450 Serra Mall, Stanford, California, 94305, UNITED STATES
| | - James S Harris
- Electrical Engineering, Stanford University, 450 Serra Mall, Stanford, California, 94305, UNITED STATES
| | - Keith Mathieson
- Institute of Photonics, University of Strathclyde, 16 Richmond St, Glasgow, G1 1XQ, UNITED KINGDOM OF GREAT BRITAIN AND NORTHERN IRELAND
| | - Daniel Palanker
- Ophthalmology, Hansen Experimental Physics Laboratory, Stanford University, 452 Lomita Mall, Stanford, California, 94305, UNITED STATES
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37
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Ho E, Shmakov A, Palanker D. Decoding network-mediated retinal response to electrical stimulation: implications for fidelity of prosthetic vision. J Neural Eng 2020; 17. [PMID: 33108781 PMCID: PMC8284336 DOI: 10.1088/1741-2552/abc535] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 10/27/2020] [Indexed: 02/07/2023]
Abstract
Objective. Patients with photovoltaic subretinal implant PRIMA demonstrated letter acuity ∼0.1 logMAR worse than sampling limit for 100 μm pixels (1.3 logMAR) and performed slower than healthy subjects tested with equivalently pixelated images. To explore the underlying differences between natural and prosthetic vision, we compare the fidelity of retinal response to visual and subretinal electrical stimulation through single-cell modeling and ensemble decoding. Approach. Responses of retinal ganglion cells (RGCs) to optical or electrical white noise stimulation in healthy and degenerate rat retinas were recorded via multi-electrode array. Each RGC was fit with linear–nonlinear and convolutional neural network models. To characterize RGC noise, we compared statistics of spike-triggered averages (STAs) in RGCs responding to electrical or visual stimulation of healthy and degenerate retinas. At the population level, we constructed a linear decoder to determine the accuracy of the ensemble of RGCs on N-way discrimination tasks. Main results. Although computational models can match natural visual responses well (correlation ∼0.6), they fit significantly worse to spike timings elicited by electrical stimulation of the healthy retina (correlation ∼0.15). In the degenerate retina, response to electrical stimulation is equally bad. The signal-to-noise ratio of electrical STAs in degenerate retinas matched that of the natural responses when 78 ± 6.5% of the spikes were replaced with random timing. However, the noise in RGC responses contributed minimally to errors in ensemble decoding. The determining factor in accuracy of decoding was the number of responding cells. To compensate for fewer responding cells under electrical stimulation than in natural vision, more presentations of the same stimulus are required to deliver sufficient information for image decoding. Significance. Slower-than-natural pattern identification by patients with the PRIMA implant may be explained by the lower number of electrically activated cells than in natural vision, which is compensated by a larger number of the stimulus presentations.
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Affiliation(s)
- Elton Ho
- Department of Physics, Stanford University, Stanford, California, UNITED STATES
| | - Alexander Shmakov
- Department of Computer Science, University of California Irvine, Irvine, California, UNITED STATES
| | - Daniel Palanker
- Hansen Experimental Physics Laboratory, Stanford University, Stanford, California, UNITED STATES
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38
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Shire DB, Gingerich MD, Wong PI, Skvarla M, Cogan SF, Chen J, Wang W, Rizzo JF. Micro-Fabrication of Components for a High-Density Sub-Retinal Visual Prosthesis. MICROMACHINES 2020; 11:mi11100944. [PMID: 33086504 PMCID: PMC7603138 DOI: 10.3390/mi11100944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 10/10/2020] [Accepted: 10/13/2020] [Indexed: 01/30/2023]
Abstract
We present a retrospective of unique micro-fabrication problems and solutions that were encountered through over 10 years of retinal prosthesis product development, first for the Boston Retinal Implant Project initiated at the Massachusetts Institute of Technology and at Harvard Medical School’s teaching hospital, the Massachusetts Eye and Ear—and later at the startup company Bionic Eye Technologies, by some of the same personnel. These efforts culminated in the fabrication and assembly of 256+ channel visual prosthesis devices having flexible multi-electrode arrays that were successfully implanted sub-retinally in mini-pig animal models as part of our pre-clinical testing program. We report on the processing of the flexible multi-layered, planar and penetrating high-density electrode arrays, surgical tools for sub-retinal implantation, and other parts such as coil supports that facilitated the implantation of the peri-ocular device components. We begin with an overview of the implantable portion of our visual prosthesis system design, and describe in detail the micro-fabrication methods for creating the parts of our system that were assembled outside of our hermetically-sealed electronics package. We also note the unique surgical challenges that sub-retinal implantation of our micro-fabricated components presented, and how some of those issues were addressed through design, materials selection, and fabrication approaches.
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Affiliation(s)
- Douglas B. Shire
- Bionic Eye Technologies, Inc., Ithaca, NY 14850, USA; (M.D.G.); (P.I.W.)
- Correspondence: ; Tel.: +1-607-339-7085
| | | | - Patricia I. Wong
- Bionic Eye Technologies, Inc., Ithaca, NY 14850, USA; (M.D.G.); (P.I.W.)
| | - Michael Skvarla
- Cornell NanoScale Science and Technology Facility, Ithaca, NY 14853, USA;
| | - Stuart F. Cogan
- Department of Bioengineering, University of Texas, Dallas, Richardson, TX 75080, USA;
| | - Jinghua Chen
- Department of Ophthalmology, University of Florida, Gainesville, FL 32611, USA;
| | - Wei Wang
- Department of Ophthalmology, University of Louisville, Louisville, KY 40292, USA;
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39
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Werginz P, Wang BY, Chen ZC, Palanker D. On optimal coupling of the 'electronic photoreceptors' into the degenerate retina. J Neural Eng 2020; 17:045008. [PMID: 32613948 PMCID: PMC10948023 DOI: 10.1088/1741-2552/aba0d2] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Objective To restore sight in atrophic age-related macular degeneration, the lost photoreceptors can be replaced with electronic implants, which replicate their two major functions: (1) converting light into an electric signal, and (2) transferring visual information to the secondary neurons in the retinal neural network—the bipolar cells (BC). We study the selectivity of BC activation by subretinal implants and dynamics of their response to pulsatile waveforms in order to optimize the electrical stimulation scheme such that retinal signal processing with 'electronic photoreceptors' remains as close to natural as possible. Approach A multicompartmental model of a BC was implemented to simulate responses of the voltage-gated calcium channels and subsequent synaptic vesicle release under continuous and pulsatile stimuli. We compared the predicted response under various frequencies, pulse durations, and alternating gratings to the corresponding experimental measurements. In addition, electric field was computed for various electrode configurations in a 3-d finite element model to assess the stimulation selectivity via spatial confinement of the field. Main results The modeled BC-mediated retinal responses were, in general, in good agreement with previously published experimental results. Kinetics of the calcium pumps and of the neurotransmitter release in ribbon synapses, which underpin the BC's temporal filtering and rectifying functions, allow mimicking the natural BC response with high frequency pulsatile stimulation, thereby preserving features of the retinal signal processing, such as flicker fusion, adaptation to static stimuli and non-linear summation of subunits in receptive field. Selectivity of the BC stimulation while avoiding direct activation of the downstream neurons (amacrine and ganglion cells—RGCs) is improved with local return electrodes. Significance If the retinal neural network is preserved to a large extent in age-related macular degeneration, selective stimulation of BCs with proper spatial and temporal modulation of the extracellular electric field may retain many features of the natural retinal signal processing and hence allow highly functional restoration of sight.
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Affiliation(s)
- Paul Werginz
- Institute for Analysis and Scientific Computing, Vienna University of Technology, Vienna, Austria. Author to whom any correspondence should be adressed
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40
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Yu ZH, Chen WJ, Liu X, Xia QY, Yang YN, Dong M, Liu JH, Guan HJ, Sun C, Feng FD, Shen QD. Folate-Modified Photoelectric Responsive Polymer Microarray as Bionic Artificial Retina to Restore Visual Function. ACS APPLIED MATERIALS & INTERFACES 2020; 12:28759-28767. [PMID: 32478503 DOI: 10.1021/acsami.0c04058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
A high-optical-resolution artificial retina system that accurately communicates with the optic nerve is the main challenge in the modern biological science and bionic field. Here, we developed a bionic artificial retina possessing phototransduction "cells" with measurements even smaller than that of the neural cells. Using the technique of micrometer processing, we constructed a pyramid-shape periodic microarray of a photoreceptor. Each "sensing cell" took advantage of polythiophene derivative/fullerene derivative (PCBM) as a photoelectric converter. Because folic acid played an essential role in eye growth, we particularly modified the polythiophene derivatives with folic acid tags. Therefore, the artificial retina could enlarge the contact area and even recognize the nerve cells to improve the consequence of nerve stimulation. We implanted the artificial retina into blinded rats' eyes. Electrophysiological analysis revealed its recovery of photosensitive function 3 months after surgery. Our work provides an innovative idea for fabricating a high-resolution bionic artificial retina system. It shows great potential in artificial intelligence and biomedicine.
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Affiliation(s)
- Zheng-Hang Yu
- Department of Polymer Science & Engineering and Key Laboratory of High Performance Polymer Materials & Technology of MOE, School of Chemistry & Chemical Engineering, Nanjing University, Nanjing 210023, China
| | - Wei-Jian Chen
- Department of Polymer Science & Engineering and Key Laboratory of High Performance Polymer Materials & Technology of MOE, School of Chemistry & Chemical Engineering, Nanjing University, Nanjing 210023, China
| | - Xi Liu
- Key Laboratory for Neuroregeneration of Jiangsu Province and Ministry of Education, Co-innovation Center of Neuroregeneration, Nantong University, Nantong 226001, China
- Eye Institute, Affiliated Hospital of Nantong University, Nantong 226001, China
| | - Qiu-Yu Xia
- Department of Polymer Science & Engineering and Key Laboratory of High Performance Polymer Materials & Technology of MOE, School of Chemistry & Chemical Engineering, Nanjing University, Nanjing 210023, China
| | - Yi-Nuo Yang
- Key Laboratory for Neuroregeneration of Jiangsu Province and Ministry of Education, Co-innovation Center of Neuroregeneration, Nantong University, Nantong 226001, China
- Eye Institute, Affiliated Hospital of Nantong University, Nantong 226001, China
| | - Mei Dong
- Department of Polymer Science & Engineering and Key Laboratory of High Performance Polymer Materials & Technology of MOE, School of Chemistry & Chemical Engineering, Nanjing University, Nanjing 210023, China
| | - Jia-Hao Liu
- Department of Polymer Science & Engineering and Key Laboratory of High Performance Polymer Materials & Technology of MOE, School of Chemistry & Chemical Engineering, Nanjing University, Nanjing 210023, China
| | - Huai-Jin Guan
- Key Laboratory for Neuroregeneration of Jiangsu Province and Ministry of Education, Co-innovation Center of Neuroregeneration, Nantong University, Nantong 226001, China
- Eye Institute, Affiliated Hospital of Nantong University, Nantong 226001, China
| | - Cheng Sun
- Key Laboratory for Neuroregeneration of Jiangsu Province and Ministry of Education, Co-innovation Center of Neuroregeneration, Nantong University, Nantong 226001, China
| | - Fu-De Feng
- Department of Polymer Science & Engineering and Key Laboratory of High Performance Polymer Materials & Technology of MOE, School of Chemistry & Chemical Engineering, Nanjing University, Nanjing 210023, China
| | - Qun-Dong Shen
- Department of Polymer Science & Engineering and Key Laboratory of High Performance Polymer Materials & Technology of MOE, School of Chemistry & Chemical Engineering, Nanjing University, Nanjing 210023, China
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41
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Seo HW, Kim N, Kim S. Fabrication of Subretinal 3D Microelectrodes with Hexagonal Arrangement. MICROMACHINES 2020; 11:mi11050467. [PMID: 32365472 PMCID: PMC7281732 DOI: 10.3390/mi11050467] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 04/26/2020] [Accepted: 04/27/2020] [Indexed: 02/01/2023]
Abstract
This study presents the fabrication of three-dimensional (3D) microelectrodes for subretinal stimulation, to accommodate adjacent return electrodes surrounding a stimulating electrode. For retinal prosthetic devices, the arrangement of return electrodes, the electrode size and spacing should be considered together, to reduce the undesired dissipation of electric currents. Here, we applied the hexagonal arrangement to the microelectrode array for the localized activation of retinal cells and better visual acuity. To provide stimuli more efficiently to non-spiking neurons, a 3D structure was created through a customized pressing process, utilizing the elastic property of the materials used in the fabrication processes. The diameter and pitch of the Pt-coated electrodes were 150 μm and 350 μm, respectively, and the height of the protruded electrodes was around 20 μm. The array consisted of 98 hexagonally arranged electrodes, supported by a flexible and transparent polydimethylsiloxane (PDMS) base, with a thickness of 140 μm. Also, the array was coated with 2 μm-thick parylene-C, except the active electrode sites, for more focused stimulation. Finally, the electrochemical properties of the fabricated microelectrodes were characterized, resulting in the mean impedance of 384.87 kΩ at 1 kHz and the charge storage capacity (CSC) of 2.83 mC·cm−2. The fabricated microelectrodes are to be combined with an integrated circuit (IC) for additional in vitro and in vivo experiments.
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Affiliation(s)
| | | | - Sohee Kim
- Correspondence: ; Tel.: +82-53-785-6217
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Tong W, Meffin H, Garrett DJ, Ibbotson MR. Stimulation Strategies for Improving the Resolution of Retinal Prostheses. Front Neurosci 2020; 14:262. [PMID: 32292328 PMCID: PMC7135883 DOI: 10.3389/fnins.2020.00262] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 03/09/2020] [Indexed: 12/17/2022] Open
Abstract
Electrical stimulation using implantable devices with arrays of stimulating electrodes is an emerging therapy for neurological diseases. The performance of these devices depends greatly on their ability to activate populations of neurons with high spatiotemporal resolution. To study electrical stimulation of populations of neurons, retina serves as a useful model because the neural network is arranged in a planar array that is easy to access. Moreover, retinal prostheses are under development to restore vision by replacing the function of damaged light sensitive photoreceptors, which makes retinal research directly relevant for curing blindness. Here we provide a progress review on stimulation strategies developed in recent years to improve the resolution of electrical stimulation in retinal prostheses. We focus on studies performed with explanted retinas, in which electrophysiological techniques are the most advanced. We summarize achievements in improving the spatial and temporal resolution of electrical stimulation of the retina and methods to selectively stimulate neurons with different visual functions. Future directions for retinal prostheses development are also discussed, which could provide insights for other types of neuromodulatory devices in which high-resolution electrical stimulation is required.
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Affiliation(s)
- Wei Tong
- National Vision Research Institute, Australian College of Optometry, Carlton, VIC, Australia
- Department of Optometry and Vision Sciences, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
- School of Physics, The University of Melbourne, Melbourne, VIC, Australia
| | - Hamish Meffin
- National Vision Research Institute, Australian College of Optometry, Carlton, VIC, Australia
- Department of Optometry and Vision Sciences, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
- Department of Biomedical Engineering, The University of Melbourne, Melbourne, VIC, Australia
| | - David J. Garrett
- School of Physics, The University of Melbourne, Melbourne, VIC, Australia
| | - Michael R. Ibbotson
- National Vision Research Institute, Australian College of Optometry, Carlton, VIC, Australia
- Department of Optometry and Vision Sciences, Melbourne School of Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
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Photovoltaic Restoration of Central Vision in Atrophic Age-Related Macular Degeneration. Ophthalmology 2020; 127:1097-1104. [PMID: 32249038 DOI: 10.1016/j.ophtha.2020.02.024] [Citation(s) in RCA: 119] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 02/14/2020] [Accepted: 02/18/2020] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Loss of photoreceptors in atrophic age-related macular degeneration results in severe visual impairment, although some peripheral vision is retained. To restore central vision without compromising the residual peripheral field, we developed a wireless photovoltaic retinal implant (PRIMA; Pixium Vision, Paris, France) in which pixels convert images projected from video glasses using near-infrared light into electric current to stimulate the nearby inner retinal neurons. DESIGN We carried out a first-in-human clinical trial to test the safety and efficacy of the prosthesis in patients with geographic atrophy (ClinicalTrials.gov identifier, NCT03333954). PARTICIPANTS Five patients with geographic atrophy zone of at least 3 optic disc diameters, no foveal light perception, and best-corrected visual acuity of 20/400 to 20/1000 in the worse-seeing study eye. METHODS The 2-mm wide, 30-μm thick chip, containing 378 pixels (each 100 μm in diameter), was implanted subretinally in the area of atrophy (absolute scotoma). MAIN OUTCOME MEASURES Anatomic outcomes were assessed with fundus photography and OCT for up to 12 months of follow-up. Prosthetic vision was assessed by mapping light perception, bar orientation, letter recognition, and Landolt C acuity. RESULTS In all patients, the prosthesis was implanted successfully under the macula, although in 2 patients, it was implanted in unintended locations: within the choroid and off center by 2 mm. All 5 patients could perceive white-yellow prosthetic visual patterns with adjustable brightness in the previous scotomata. The 3 with optimal placement of the implant demonstrated prosthetic acuity of 20/460 to 20/550, and the patient with the off-center implant demonstrated 20/800 acuity. Residual natural acuity did not decrease after implantation in any patient. CONCLUSIONS Implantation of the PRIMA did not decrease the residual natural acuity, and it restored visual sensitivity in the former scotoma in each of the 5 patients. In 3 patients with the proper placement of the chip, prosthetic visual acuity was only 10% to 30% less than the level expected from the pixel pitch (20/420). Therefore, the use of optical or electronic magnification in the glasses as well as smaller pixels in future implants may improve visual acuity even further.
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