nach oben

Spektrum der Augenheilkunde

Erschienen in:

01.06.2016 | DFP-Fortbildung

Sehprothesen

verfasst von: Prof. Dr. P. Walter

Erschienen in: Spektrum der Augenheilkunde | Ausgabe 3/2016

Einloggen, um Zugang zu erhalten

Zusammenfassung

Sensorische Neuroprothesen zur Wiederherstellung von Sehfunktionen stellen einen technischen Ansatz zur Behandlung bisher nicht therapierbarer Erblindungen dar. Diese Prothesen bestehen aus einem technischen Sensor und einer implantierbaren Reizelektrodenmatrix im visuellen System. Die Sensorinformation wird in digitalen Signalprozessoren so aufbereitet, dass Stimulationspulsfolgen bestimmt werden können, die dann an der implantierten Multielektrodenmatrix bereitgestellt werden. Die Versorgung der Implantate mit Energie und den Daten zu den Reizpulsen erfolgt entweder über direkte Kabelanbindungen oder mithilfe induktiver telemetrischer Systeme. Es sind derzeit 2 Retinaimplantatsysteme für die Anwendung bei Patienten mit Retinitis pigmentosa zugelassen. Mit beiden Systemen lassen sich basale Sehfunktionen wiederherstellen. Die Komplikationsrate ist in Anbetracht des komplexen Eingriffes akzeptabel. Andere Systeme befinden sich noch in der Entwicklung, wobei Studien zur Zulassung derzeit von mehreren Herstellern und Konsortien vorbereitet werden.

Vorheriger Artikel Indirekte traumatische Optikusneuropathie nach Fahrradsturz

Brindley GS, Lewin WS (1968) The sensations produced by electrical stimulation of the visual cortex. J Physiol (Lond) 196(2):479–493CrossRef

Rizzo JF, Wyatt J (1997) Prospects for a visual prosthesis. Neuroscientist 3(4):251–262CrossRef

Rizzo JF, Wyatt J, Humayun M, de Juan E, Liu W, Chow A et al (2001) Retinal prosthesis: an encouraging first decade with major challenges ahead. Ophthalmology 108(1):13–14CrossRefPubMed

Wilson BS, Dorman MF (2008) Cochlear implants: a remarkable past and a brilliant future. Hear Res 242(1–2):3–21CrossRefPubMedPubMedCentral

Eckmiller R (1997) Learning retina implants with epiretinal contacts. Ophthal Res 29(5):281–289CrossRef

Eckmiller R, Neumann D, Baruth O (2005) Tunable retina encoders for retina implants: why and how. J Neural Eng 2(1):91–104CrossRef

Niina O, Hirotaka T, Yoshiuki K, Toshiya K, Risato K, Tetsu T et al (2011) Comparison of electrode materials for the use of retinal prosthesis. Biomed Mater Eng 21(2):83–97. (IOS Press)

Ray A, Weiland JD (2010) Structures, materials, and processes at the electrode to tissue interface, Chapter 6. In: Dagnelie G (Hrsg) Visual Prosthetics. Springer Science + Business Media, New York, S 113–135

Loudin J, Butterwick A, Huie P, Palanker D (2011) Delivery of Information and Power to the Implant, Integration of the Electrode Array with the Retina, and Sefety of Chronic Stimulation, Chapter 7. In: Dagnelie G (Hrsg) Visual Prosthetics. Springer Science + Business Media, New York, S 137–158CrossRef

10.

Fujikado T, Kamei M, Sakaguchi H, Kanda H, Morimoto T, Ikuno Y et al (2012) Clinical trial of chronic implantation of suprachoroidal-transretinal stimulation system for retinal prosthesis. Sensors Materials 24(4):181–187

11.

Fujikado T, Morimoto T, Kanda H, Kusaka S, Nakauchi K, Ozawa M et al (2007) Evaluation of phosphenes elicited by extraocular stimulation in normals and by suprachoroidal-transretinal stimulation in patients with retinitis pigmentosa. Graefes Arch Clin Exp Ophthalmol 245(10):1411–1419CrossRefPubMed

12.

Fujikado T, Kamei M, Sakaguchi H, Kanda H, Morimoto T, Ikuno Y et al (2010) Testing of semichronically implanted retinal prosthesis by suprachoroidal-transretinal stimulation in patients with retinitis pigmentosa. Invest Ophthalmol Vis Sci 52(7):4726–4733CrossRef

13.

Ayton LN, Blamey PJ, Guymer RH, Luu CD, Nayagam DAX, Sinclair NC et al (2014) First-in-human trial of a novel suprachoroidal retinal prosthesis. PLoS One 9(12):e115239CrossRefPubMedPubMedCentral

14.

Shivdasani MN, Sinclair NC, Dimitrov PN, Varsamidis M, Ayton LN, Luu CD et al (2014) Factors affecting perceptual thresholds in a suprachoroidal retinal prosthesis. Invest Ophthalmol Vis Sci 55(10):6467–6481CrossRefPubMed

15.

Chow AY, Chow VY, Packo KH, Pollack JS, Peyman GA, Schuchard R (2003) The artificial silicon retina microchip for the treatment of vision loss from retinitis pigmentosa. Arch Ophthalmol JAMA 122(4):460–469CrossRef

16.

Peachey NS, Chow AY (1999) Subretinal implantation of semiconductor-based photodiodes: progress and challenges. J Rehabil Res Dev 36(4):371–376PubMed

17.

Pardue MT, Phillips MJ, Yin H, Sippy BD, Webb-Wood S, Chow AY et al (2005) Neuroprotective effect of subretinal implants in the RCS rat. Invest Ophthalmol Vis Sci 46(2):674–682CrossRefPubMed

18.

Stingl K, Greppmaier U, Wilhelm B, Zrenner E (2010) [Subretinal visual implants]. Klin Monbl Augenheilkd 227(12):940–945CrossRefPubMed

19.

Stingl K, Bartz-Schmidt KU, Besch D, Gekeler F, Greppmaier U, Hörtdörfer G et al (2012) [What can blind patients see in daily life with the subretinal Alpha IMS implant? Current overview from the clinical trial in Tübingen]. Ophthalmologe 109(2):136–141CrossRefPubMed

20.

Stingl K, Bartz-Schmidt KU, Gekeler F, Kusnyerik A, Sachs H, Zrenner E (2013) Functional outcome in subretinal electronic implants depends on foveal eccentricity. Invest Ophthalmol Vis Sci 54(12):7658–7665CrossRefPubMed

21.

Stingl K, Bartz-Schmidt KU, Besch D, Braun A, Bruckmann A, Gekeler F et al (2013) Artificial vision with wirelessly powered subretinal electronic implant alpha-IMS. Proc Biol Sci 280(1757):20130077CrossRefPubMedPubMedCentral

22.

Stingl K, Bartz-Schmidt KU, Besch D, Chee CK, Cottriall CL, Gekeler F et al (2015) Subretinal visual implant alpha IMS – clinical trial interim report. Vision Res 111:149–160CrossRefPubMed

23.

Rizzo JF, Shire DB, Kelly SK, Troyk P, Gingerich M, McKee B et al (2011) Overview of the boston retinal prosthesis: challenges and opportunities to restore useful vision to the blind. Conf Proc IEEE Eng Med Biol Soc 2011:7492–7495PubMed

24.

Shire DB, Ellersick W, Kelly SK, Doyle P, Priplata A, Drohan W et al (2012) ASIC design and data communications for the Boston retinal prosthesis. Conf Proc IEEE Eng Med Biol Soc 2012:292–295PubMedPubMedCentral

25.

Kelly SK, Shire DB, Chen J, Doyle P, Gingerich MD, Cogan SF et al (2011) A hermetic wireless subretinal neurostimulator for vision prostheses. IEEE Trans Biomed Eng 58(11):3197–3205CrossRefPubMedPubMedCentral

26.

Lorach H, Goetz G, Smith R, Lei X, Mandel Y, Kamins T et al (2015) Photovoltaic restoration of sight with high visual acuity. Nat Med 21(5):476–254. (Nature Publishing Group)CrossRefPubMedPubMedCentral

27.

Wang L, Mathieson K, Kamins TI, Loudin JD, Galambos L, Goetz G et al (2012) Photovoltaic retinal prosthesis: implant fabrication and performance. J Neural Eng 9(4):046014CrossRefPubMedPubMedCentral

28.

Palanker D, Vankov A, Huie P, Chan I, Butterwick A, Marmor MF et al (2006) Development of a high-resolution optoelectronic retinal prosthesis. Faseb J 20(5):A844–A844

29.

Walter P, Szurman P, Vobig M, Berk H, Lüdtke-Handjery HC, Richter H et al (1999) Successful long-term implantation of electrically inactive epiretinal microelectrode arrays in rabbits. Retina 19(6):546–552CrossRefPubMed

30.

Walter P, Kisvárday ZF, Görtz M, Alteheld N, Rössler G, Stieglitz T et al (2005) Cortical activation via an implanted wireless retinal prosthesis. Invest Ophthalmol Vis Sci 46(5):1780–1785CrossRefPubMed

31.

Roessler G, Laube T, Brockmann C, Kirschkamp T, Mazinani B, Goertz M et al (2009) Implantation and explantation of a wireless epiretinal retina implant device: observations during the EPIRET3 prospective clinical trial. Invest Ophthalmol Vis Sci 50(6):3003–3008CrossRefPubMed

32.

Menzel-Severing J, Laube T, Brockmann C, Bornfeld N, Mokwa W, Mazinani B et al (2011) Implantation and explantation of an active epiretinal visual prosthesis: 2-year follow-up data from the EPIRET3 prospective clinical trial. Eye (Lond) 26(4):501–509CrossRef

33.

Klauke S, Goertz M, Rein S, Hoehl D, Thomas U, Eckhorn R et al (2011) Stimulation with a wireless intraocular epiretinal implant elicits visual percepts in blind humans. Invest Ophthalmol Vis Sci 52(1):449–455CrossRefPubMed

34.

Humayun MS, Dorn JD, da Cruz L, Dagnelie G, Sahel J-A, Stanga PE et al (2011) Interim results from the international trial of Second Sight’s visual prosthesis. Ophthalmology 119(4):779–788CrossRef

35.

Humayun MS, Dorn JD, Ahuja AK, Caspi A, Filley E, Dagnelie G et al (2009) Preliminary 6 month results from the Argus II epiretinal prosthesis feasibility study. Conf Proc IEEE Eng Med Biol Soc 2009:4566–4568PubMedPubMedCentral

36.

da Cruz L, Coley BF, Dorn J, Merlini F, Filley E, Christopher P et al (2013) The Argus II epiretinal prosthesis system allows letter and word reading and long-term function in patients with profound vision loss. Br J Ophthalmol 97(5):632–636CrossRefPubMedPubMedCentral

37.

Barry MP, Dagnelie G, Argus II, Study Group (2012) Use of the Argus II retinal prosthesis to improve visual guidance of fine hand movements. Invest Ophthalmol Vis Sci 53(9):5095–5101CrossRefPubMedPubMedCentral

38.

Rizzo S, Belting C, Cinelli L, Allegrini L, Genovesi-Ebert F, Barca F et al (2014) The Argus II Retinal Prosthesis: twelve-month outcomes from a single-study center. Am J Ophthalmol 157(6):1282–1290CrossRefPubMed

39.

Ho AC, Humayun MS, Dorn JD, da Cruz L, Dagnelie G, Handa J, Barale PO, Sahel JA, Stanga PE, Hafezi F, Safran AB, Salzmann J, Santos A, Birch D, Spencer R, Cideciyan AV, de Juan E, Duncan JL, Eliott D, Fawzi A, Olmos de Koo LC, Brown GC, Haller JA, Regillo CD, Del Priore LV, Arditi A, Geruschat DR, Greenberg RJ, Argus II Study Group (2015) Long-term results from an epiretinal prosthesis to restore sight to the blind. Ophthalmology 122:1547–1554CrossRefPubMed

40.

Hornig R, Zehnder T, Velikay-Parel M, Laube T, Feucht M, Richard G (2007) The IMI retinal implant system. In: Humayun MS, Weiland JD, Chader G, Greenbaum E (Hrsg) Artifcial vision, biological and medical physics, biomedical engineering. Springer, New York, S 111–128

41.

Matthaei M, Zeitz O, Keserü M, Wagenfeld L, Hornig R, Post N et al (2011) Progress in the development of vision prostheses. Ophthalmologica 225(4):187–192CrossRefPubMed

42.

Velikay-Parel M, Ivastinovic D, Koch M, Hornig R, Dagnelie G, Richard G et al (2007) Repeated mobility testing for later artificial visual function evaluation. J Neural Eng 4(1):102–107CrossRef

43.

Delbeke J, Oozeer M, Veraart C (2003) Position, size and luminosity of phosphenes generated by direct optic nerve stimulation. Vision Res 43(9):1091–1102CrossRefPubMed

44.

Brelén ME, Duret F, Gérard B, Delbeke J, Veraart C (2005) Creating a meaningful visual perception in blind volunteers by optic nerve stimulation. J Neural Eng 2(1):22–28CrossRef

45.

Duret F, Brelén ME, Lambert V, Gérard B, Delbeke J, Veraart C (2006) Object localization, discrimination, and grasping with the optic nerve visual prosthesis. Restor Neurol Neurosci 24(1):31–40PubMed

46.

Veraart C, Wanet-Defalque M-C, Gérard B, Vanlierde A, Delbeke J (2003) Pattern recognition with the optic nerve visual prosthesis. Artif Organs 27(11):996–1004CrossRefPubMed

47.

Sun J, Chen Y, Chai X, Ren Q, Li L (2013) Penetrating electrode stimulation of the rabbit optic nerve: parameters and effects on evoked cortical potentials. Graefes Arch Clin Exp Ophthalmol 251(11):2545–2554CrossRefPubMed

48.

Lu Y, Yan Y, Chai X, Ren Q, Chen Y, Li L (2013) Electrical stimulation with a penetrating optic nerve electrode array elicits visuotopic cortical responses in cats. J Neural Eng 10(3):036022CrossRefPubMed

49.

Chai X, Li L, Wu K, Zhou C, Cao P, Ren Q (2008) C-sight visual prostheses for the blind – optic nerve stimulation with penetrating electrode array. IEEE Eng Med Biol Mag 27(5):20–28CrossRefPubMed

50.

Sui X, Han Z, Zhou D, Ren Q (2012) Mechanical analysis and fabrication of a penetrating silicon microprobe as an artificial optic nerve visual prosthesis. Int J Artif Organs 35(1):34–44CrossRefPubMed

51.

Pezaris JS, Eskandar EN (2009) Getting signals into the brain: visual prosthetics through thalamic microstimulation. Neurosurg Focus 27(1):E6CrossRefPubMedPubMedCentral

52.

Vurro M, Crowell AM, Pezaris JS (2014) Simulation of thalamic prosthetic vision: reading accuracy, speed, and acuity in sighted humans. Front Hum Neurosci 8:816CrossRefPubMedPubMedCentral

53.

Brindley GS (1982) Effects of electrical stimulation of the visual cortex. Hum Neurobiol 1(4):281–283PubMed

54.

Dobelle WH, MG M, GIRVIN JP (1974) Artificial vision for blind – electrical-stimulation of visual-cortex offers hope for a functional prosthesis. Science 183(4123):440–444CrossRefPubMed

55.

Dobelle WH (2000) Artificial vision for the blind by connecting a television camera to the visual cortex. ASAIO J 46(1):3–9CrossRefPubMed

56.

Lee VK, Nau AC, Laymon C, Chan KC, Rosario BL, Fisher C (2014) Successful tactile based visual sensory substitution use functions independently of visual pathway integrity. Front Hum Neurosci 8:291PubMedPubMedCentral

Titel: Sehprothesen
verfasst von: Prof. Dr. P. Walter
Publikationsdatum: 01.06.2016
Verlag: Springer Vienna
Erschienen in: Spektrum der Augenheilkunde / Ausgabe 3/2016
Print ISSN: 0930-4282
Elektronische ISSN: 1613-7523
DOI: https://doi.org/10.1007/s00717-016-0299-4

Springer Medizin Österreich

Zusammenfassung

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 3/2016

IVOM in Österreich 2013 – Eine Auswertung anhand realer Patientenzahlen

Editorial

Argus II Retina Implantat bei an Retinopathia pigmentosa erblindeter Patientin

Arbeitsablauf zur Behandlung des Trockenen Auges, ein Versuch der Zuordnung von Diagnose zur Therapie

Indirekte traumatische Optikusneuropathie nach Fahrradsturz

Macular hole treated by the inverted internal limiting membrane flap technique: case report