title: Prosthetic vision: devices, patient outcomes and retinal research.
abstract: Retinal disease and its associated retinal degeneration can lead to the loss of photoreceptors and therefore, profound blindness. While retinal degeneration destroys the photoreceptors, the neural circuits that convey information from the eye to the brain are sufficiently preserved to make it possible to restore sight using prosthetic devices. Typically, these devices consist of a digital camera and an implantable neurostimulator. The image sensor in a digital camera has the same spatiotopic arrangement as the photoreceptors of the retina. Therefore, it is possible to extract meaningful spatial information from an image and deliver it via an array of stimulating electrodes directly to the surviving retinal circuits. Here, we review the structure and function of normal and degenerate retina. The different approaches to prosthetic implant design are described in the context of human and preclinical trials. In the last section, we review studies of electrical properties of the retina and its response to electrical stimulation. These types of investigation are currently assessing a number of key challenges identified in human trials, including stimulation efficacy, spatial localisation, desensitisation to repetitive stimulation and selective activation of retinal cell populations.
authors.affiliation: National Vision Research Institute, Australian College of Optometry, Carlton, Victoria, Australia.|ARC Centre of Excellence for Integrative Brain Function and Department of Optometry and Vision Sciences, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Alex E
authors.initials: AE
authors.lastname: Hadjinicolaou
authors.affiliation: National Vision Research Institute, Australian College of Optometry, Carlton, Victoria, Australia.|ARC Centre of Excellence for Integrative Brain Function and Department of Optometry and Vision Sciences, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Hamish
authors.initials: H
authors.lastname: Meffin
authors.affiliation: National Vision Research Institute, Australian College of Optometry, Carlton, Victoria, Australia.|Department of Electrical and Electronic Engineering, The University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Matias I
authors.initials: MI
authors.lastname: Maturana
authors.affiliation: National Vision Research Institute, Australian College of Optometry, Carlton, Victoria, Australia.|ARC Centre of Excellence for Integrative Brain Function and Department of Optometry and Vision Sciences, University of Melbourne, Parkville, Victoria, Australia.|Department of Electrical and Electronic Engineering, The University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Shaun L
authors.initials: SL
authors.lastname: Cloherty
authors.affiliation: National Vision Research Institute, Australian College of Optometry, Carlton, Victoria, Australia.|ARC Centre of Excellence for Integrative Brain Function and Department of Optometry and Vision Sciences, University of Melbourne, Parkville, Victoria, Australia.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Ibbotson
mesh_terms: D000818:Animals; D006801:Humans; D019919:Prosthesis Implantation / Q000379:methods*; D012164:Retinal Diseases / Q000503:physiopathology / Q000601:surgery*; D014785:Vision, Ocular; D014796:Visual Perception; D057488:Visual Prosthesis
keywords: human implant; retinal degeneration; retinal prosthesis; vision loss; vision prosthesis