title: Retinal stimulation strategies to restore vision: Fundamentals and systems.
abstract: Retinal degeneration, a leading cause of blindness worldwide, is primarily characterized by the dysfunctional/degenerated photoreceptors that impair the ability of the retina to detect light. Our group and others have shown that bioelectronic retinal implants restore useful visual input to those who have been blind for decades. This unprecedented approach of restoring sight demonstrates that patients can adapt to new visual input, and thereby opens up opportunities to not only improve this technology but also develop alternative retinal stimulation approaches. These future improvements or new technologies could have the potential of selectively stimulating specific cell classes in the inner retina, leading to improved visual resolution and color vision. In this review we will detail the progress of bioelectronic retinal implants and future devices in this genre as well as discuss other technologies such as optogenetics, chemical photoswitches, and ultrasound stimulation. We will discuss the principles, biological aspects, technology development, current status, clinical outcomes/prospects, and challenges for each approach. The review will cover functional imaging documented cortical responses to retinal stimulation in blind patients.
authors.affiliation: USC Eye Institute, Institute for Biomedical Therapeutics, University of Southern California, Los Angeles, CA 90033, USA. Electronic address: lyue@usc.edu.
authors.forename: Lan
authors.initials: L
authors.lastname: Yue
authors.affiliation: USC Eye Institute, Institute for Biomedical Therapeutics, University of Southern California, Los Angeles, CA 90033, USA.
authors.forename: James D
authors.initials: JD
authors.lastname: Weiland
authors.affiliation: Neural Circuit Laboratories, Friedrich Miescher Institute for Biomedical Research, Maulbeerstrasse 66, 4058 Basel, Switzerland; Department of Ophthalmology, University of Basel, Basel, Switzerland.
authors.forename: Botond
authors.initials: B
authors.lastname: Roska
authors.affiliation: USC Eye Institute, Institute for Biomedical Therapeutics, University of Southern California, Los Angeles, CA 90033, USA.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Humayun
mesh_terms: D000818:Animals; D004734:Energy Metabolism; D006801:Humans; D062308:Optogenetics; D020127:Recovery of Function / Q000502:physiology*; D012160:Retina / Q000502:physiology*; D012162:Retinal Degeneration / Q000628:therapy*; D014785:Vision, Ocular / Q000502:physiology*; D057488:Visual Prosthesis
keywords: Bioelectronic; Optogenetics; Photoreceptor degeneration; Photoswitches; Prosthesis; Retinal stimulation; Ultrasound; Vision restoration