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Implantation of episcleral electrodes via anterior orbitotomy for stimulation of the retina with induced photoreceptor degeneration: an in vivo feasibility study on a conceptual visual prosthesis

  • Experimental Research
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Summary

Background. A visual prosthesis is a conceptual device designed to harnesses the function of residual afferent neurons in the visual pathway to produce artificial vision. Such implant, when applied to stimulate the vitreous surface of the retina, has proven feasible in producing the perception of light in both animals and humans. However the practicality of such device has been challenged by the difficulty of surgical access and the risks of damaging the neuroretina. Positioning a visual implant over the scleral surface of the eye could present a safer alternative but this stimulation modality has not been tested in diseased retinas and little is known about the altered electrophysiological properties of the retina in influencing the feasibility of such approach.

Methods. Experimental photoreceptor degeneration was induced in four pigmented rabbit eyes with systematic administration of a retinotoxic agent, sodium iodate. A multielectrode array was implanted onto the surface of the sclera to target the central and peripheral parts of the retina via an anterior orbitotomy approach. The efficacy of retinal stimulation was assessed by recording electrical evoked potential over the primary visual cortex.

Findings. The electrical evoked potentials were obtained from both injected and control eyes. The charge density thresholds were found to be similar in both groups and were below the bioelectric safety limit. Spatially differentiated cortical activation profiles were obtained from the central and peripheral retina and the pattern of activation corresponded to the retinotopography of the rabbit primary visual cortex.

Conclusion. This study proves that episcleral stimulation of the retina is a feasible alternative to intraocular approaches for the development of a visual prosthesis for retinas with photoreceptor loss.

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References

  • GS Brindley WS Lewin (1968) ArticleTitleThe sensations produced by electrical stimulation of the visual cortex J Physiol 196 479–493 Occurrence Handle4871047 Occurrence Handle1:STN:280:DyaF1c3nt1Kksw%3D%3D

    PubMed  CAS  Google Scholar 

  • MM Brown GC Brown S Sharma J Kistler H Brown (2001) ArticleTitleUtility values associated with blindness in an adult population Br J Ophthalmol 85 327–331 Occurrence Handle11222340 Occurrence Handle10.1136/bjo.85.3.327 Occurrence Handle1:STN:280:DC%2BD3M7ps1Cjug%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • SB Brummer MJ Turner (1977) ArticleTitleElectrochemical considerations for safe electrical stimulation of the nervous system with platinum electrodes IEEE Trans Biomed Eng 24 59–63 Occurrence Handle851475 Occurrence Handle10.1109/TBME.1977.326218 Occurrence Handle1:STN:280:DyaE2s%2Fpt1OmsA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • AY Chow VY Chow (1997) ArticleTitleSubretinal electrical stimulation of the rabbit retina Neurosci Lett 225 13–16 Occurrence Handle9143006 Occurrence Handle10.1016/S0304-3940(97)00185-7 Occurrence Handle1:CAS:528:DyaK2sXisVeltLs%3D

    Article  PubMed  CAS  Google Scholar 

  • WH Dobelle (2000) ArticleTitleArtificial vision for the blind by connecting a television camera to the visual cortex Asaio J 46 3–9 Occurrence Handle10667705 Occurrence Handle10.1097/00002480-200001000-00002 Occurrence Handle1:STN:280:DC%2BD3c7ivFWltQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • F Gekeler K Kobuch HN Schwahn A Stett K Shinoda E Zrenner (2004) ArticleTitleSubretinal electrical stimulation of the rabbit retina with acutely implanted electrode arrays Graefes Arch Clin Exp Ophthalmol 242 587–596 Occurrence Handle15197555 Occurrence Handle10.1007/s00417-004-0862-6

    Article  PubMed  Google Scholar 

  • RJ Greenberg (2000) ArticleTitleVisual prostheses: a review Neuromodulation 3 161–165 Occurrence Handle10.1046/j.1525-1403.2000.00161.x

    Article  Google Scholar 

  • L Hesse T Schanze M Wilms M Eger (2000) ArticleTitleImplantation of retina stimulation electrodes and recording of electrical stimulation responses in the visual cortex of the cat Graefes Arch Clin Exp Ophthalmol 238 840–845 Occurrence Handle11127571 Occurrence Handle10.1007/s004170000197 Occurrence Handle1:STN:280:DC%2BD3M%2Fps1Smtg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • M Humayun Y Sato R Propst E de Juan SuffixJr (1995) ArticleTitleCan potentials from the visual cortex be elicited electrically despite severe retinal degeneration and a markedly reduced electroretinogram? Ger J Ophthalmol 4 57–64 Occurrence Handle7728112 Occurrence Handle1:STN:280:DyaK2M3ksFaqsQ%3D%3D

    PubMed  CAS  Google Scholar 

  • MS Humayun E de Juan SuffixJr G Dagnelie RJ Greenberg RH Propst DH Phillips (1996) ArticleTitleVisual perception elicited by electrical stimulation of retina in blind humans Arch Ophthalmol 114 40–46 Occurrence Handle8540849 Occurrence Handle1:STN:280:DyaK287jtlaisw%3D%3D

    PubMed  CAS  Google Scholar 

  • MS Humayun JD Weiland GY Fujii R Greenberg R Williamson J Little B Mech V Cimmarusti G Van Boemel G Dagnelie E de Juan (2003) ArticleTitleVisual perception in a blind subject with a chronic microelectronic retinal prosthesis Vision Res 43 2573–2581 Occurrence Handle13129543 Occurrence Handle10.1016/S0042-6989(03)00457-7

    Article  PubMed  Google Scholar 

  • DW Hunt P Margaron (2003) ArticleTitleStatus of therapies in development for the treatment of age-related macular degeneration Drugs 6 464–469 Occurrence Handle1:CAS:528:DC%2BD3sXkvFKjsLg%3D

    CAS  Google Scholar 

  • L Hyman (1987) ArticleTitleEpidemiology of eye disease in the elderly Eye 1 IssueIDPt 2 330–341 Occurrence Handle3653439

    PubMed  Google Scholar 

  • AM Khan MA Varvares (2006) ArticleTitleTraditional approaches to the orbit Otolaryngol Clin North Am 39 895–909 Occurrence Handle16982253 Occurrence Handle10.1016/j.otc.2006.08.008

    Article  PubMed  Google Scholar 

  • W Koller R Pahwa K Busenbark J Hubble S Wilkinson A Lang P Tuite E Sime A Lazano R Hauser T Malapira D Smith D Tarsy E Miyawaki T Norregaard T Kormos CW Olanow (1997) ArticleTitleHigh-frequency unilateral thalamic stimulation in the treatment of essential and parkinsonian tremor Ann Neurol 42 292–299 Occurrence Handle9307249 Occurrence Handle10.1002/ana.410420304 Occurrence Handle1:STN:280:DyaK2svltVyjug%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • L Lamberg (1998) ArticleTitleBlind people often sleep poorly; research shines light on therapy JAMA 280 1123–1124 Occurrence Handle9777795 Occurrence Handle10.1001/jama.280.13.1123 Occurrence Handle1:STN:280:DyaK1cvkvFahtw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • R Laszig N Marangos P Sollmann R Ramsden B Fraysse T Lenarz H Rask-Andersen G Bredberg O Sterkers M Manrique B Nevison (1997) ArticleTitleInitial results from the clinical trial of the nucleus 21-channel auditory brain stem implant Am J Otol 18 S160 Occurrence Handle9391644 Occurrence Handle1:STN:280:DyaK1c%2FltlWgsA%3D%3D

    PubMed  CAS  Google Scholar 

  • O Lindvall Z Kokaia A Martinez-Serrano (2004) ArticleTitleStem cell therapy for human neurodegenerative disorders – how to make it work Nat Med 10 IssueIDSuppl S42–S50 Occurrence Handle15272269 Occurrence Handle10.1038/nm1064 Occurrence Handle1:CAS:528:DC%2BD2cXlvVKgsrg%3D

    Article  PubMed  CAS  Google Scholar 

  • GE Loeb (1990) ArticleTitleCochlear prosthetics Annu Rev Neurosci 13 357–371 Occurrence Handle2183680 Occurrence Handle10.1146/annurev.ne.13.030190.002041 Occurrence Handle1:STN:280:DyaK3c3isFKitw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • DM Long (1977) ArticleTitleElectrical stimulation for the control of pain Arch Surg 112 884–888 Occurrence Handle301734 Occurrence Handle1:STN:280:DyaE2s3itVyktw%3D%3D

    PubMed  CAS  Google Scholar 

  • E Margalit M Maia JD Weiland RJ Greenberg GY Fujii G Torres DV Piyathaisere TM O’Hearn W Liu G Lazzi G Dagnelie DA Scribner E de Juan SuffixJr MS Humayun (2002) ArticleTitleRetinal prosthesis for the blind Surv Ophthalmol 47 335–356 Occurrence Handle12161210 Occurrence Handle10.1016/S0039-6257(02)00311-9

    Article  PubMed  Google Scholar 

  • MN Nadig (1999) ArticleTitleDevelopment of a silicon retinal implant: cortical evoked potentials following focal stimulation of the rabbit retina with light and electricity Clin Neurophysiol 110 1545–1553 Occurrence Handle10479021 Occurrence Handle10.1016/S1388-2457(99)00027-9 Occurrence Handle1:STN:280:DyaK1Mvgs1Wgtw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • K Nakauchi T Fujikado H Kanda T Morimoto JS Choi Y Ikuno H Sakaguchi M Kamei M Ohji T Yagi S Nishimura H Sawai Y Fukuda Y Tano (2005) ArticleTitleTransretinal electrical stimulation by an intrascleral multichannel electrode array in rabbit eyes Graefes Arch Clin Exp Ophthalmol 243 169–174 Occurrence Handle15586287 Occurrence Handle10.1007/s00417-004-1060-2

    Article  PubMed  Google Scholar 

  • AM Potts J Inoue (1970) ArticleTitleThe electrically evoked response of the visual system (EER). 3. Further contribution to the origin of the EER Invest Ophthalmol 9 814–819 Occurrence Handle5479448 Occurrence Handle1:STN:280:DyaE3M%2Fjt1yltw%3D%3D

    PubMed  CAS  Google Scholar 

  • JF Rizzo Suffix3rd S Goldbaum M Shahin TJ Denison J Wyatt (2004) ArticleTitleIn vivo electrical stimulation of rabbit retina with a microfabricated array: strategies to maximize responses for prospective assessment of stimulus efficacy and biocompatibility Restor Neurol Neurosci 22 429–443 Occurrence Handle15798362 Occurrence Handle1:CAS:528:DC%2BD2MXislamu7o%3D

    PubMed  CAS  Google Scholar 

  • JF Rizzo Suffix3rd J Wyatt J Loewenstein S Kelly D Shire (2003) ArticleTitlePerceptual efficacy of electrical stimulation of human retina with a microelectrode array during short-term surgical trials Invest Ophthalmol Vis Sci 44 5362–5369 Occurrence Handle14638739 Occurrence Handle10.1167/iovs.02-0817

    Article  PubMed  Google Scholar 

  • RD Ross (1998) ArticleTitleIs perception of light useful to the blind patient? Arch Ophthalmol 116 236–238 Occurrence Handle9488278 Occurrence Handle1:STN:280:DyaK1c7kslKjsA%3D%3D

    PubMed  CAS  Google Scholar 

  • HG Sachs F Gekeler H Schwahn W Jakob M Kohler F Schulmeyer J Marienhagen U Brunner C Framme (2005) ArticleTitleImplantation of stimulation electrodes in the subretinal space to demonstrate cortical responses in Yucatan minipig in the course of visual prosthesis development Eur J Ophthalmol 15 493–499 Occurrence Handle16001384 Occurrence Handle1:STN:280:DC%2BD2MzkvVGqtA%3D%3D

    PubMed  CAS  Google Scholar 

  • H Sakaguchi T Fujikado X Fang H Kanda M Osanai K Nakauchi Y Ikuno M Kamei T Yagi S Nishimura M Ohji T Yagi Y Tano (2004) ArticleTitleTransretinal electrical stimulation with a suprachoroidal multichannel electrode in rabbit eyes Jpn J Ophthalmol 48 256–261 Occurrence Handle15175918 Occurrence Handle10.1007/s10384-004-0055-1

    Article  PubMed  Google Scholar 

  • T Schanze M Wilms M Eger L Hesse R Eckhorn (2002) ArticleTitleActivation zones in cat visual cortex evoked by electrical retina stimulation Graefes Arch Clin Exp Ophthalmol 240 947–954 Occurrence Handle12486519 Occurrence Handle10.1007/s00417-002-0577-5

    Article  PubMed  Google Scholar 

  • EM Schmidt MJ Bak FT Hambrecht CV Kufta DK O’Rourke P Vallabhanath (1996) ArticleTitleFeasibility of a visual prosthesis for the blind based on intracortical microstimulation of the visual cortex Brain 119 IssueIDPt 2 507–522 Occurrence Handle8800945 Occurrence Handle10.1093/brain/119.2.507

    Article  PubMed  Google Scholar 

  • HN Schwahn F Gekeler K Kohler K Kobuch HG Sachs F Schulmeyer W Jakob VP Gabel E Zrenner (2001) ArticleTitleStudies on the feasibility of a subretinal visual prosthesis: data from Yucatan micropig and rabbit Graefes Arch Clin Exp Ophthalmol 239 961–967 Occurrence Handle11820703 Occurrence Handle10.1007/s004170100368 Occurrence Handle1:STN:280:DC%2BD38%2FptFyiug%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • JH Seaber R Machemer D Eliott EG Buckley E de Juan DF Martin (1995) ArticleTitleLong-term visual results of children after initially successful vitrectomy for stage V retinopathy of prematurity Ophthalmology 102 199–204 Occurrence Handle7862407 Occurrence Handle1:STN:280:DyaK2M7ms1Gitw%3D%3D

    PubMed  CAS  Google Scholar 

  • HA Shah SR Montezuma JF Rizzo Suffix3rd (2006) ArticleTitleIn vivo electrical stimulation of rabbit retina: effect of stimulus duration and electrical field orientation Exp Eye Res 83 247–254 Occurrence Handle16750527 Occurrence Handle10.1016/j.exer.2005.11.023 Occurrence Handle1:CAS:528:DC%2BD28Xls1Gqsb0%3D

    Article  PubMed  CAS  Google Scholar 

  • S Suzuki MS Humayun JD Weiland SJ Chen E Margalit DV Piyathaisere E de Juan SuffixJr (2004) ArticleTitleComparison of electrical stimulation thresholds in normal and retinal degenerated mouse retina Jpn J Ophthalmol 48 345–349 Occurrence Handle15295659

    PubMed  Google Scholar 

  • HR Taylor JE Keeffe HT Vu JJ Wang E Rochtchina ML Pezzullo P Mitchell (2005) ArticleTitleVision loss in Australia Med J Aust 182 565–568 Occurrence Handle15938683

    PubMed  Google Scholar 

  • JM Thompson CN Woolsey SA Talbot (1950) ArticleTitleVisual areas I and II of cerebral cortex of rabbit J Neurophysiol 13 277–288 Occurrence Handle15422390 Occurrence Handle1:STN:280:DyaG3c%2Fjt1ShsA%3D%3D

    PubMed  CAS  Google Scholar 

  • JE Turner JR Blair M Seiler R Aramant TW Laedtke ET Chappell L Clarkson (1988) ArticleTitleRetinal transplants and optic nerve bridges: possible strategies for visual recovery as a result of trauma or disease Int Rev Neurobiol 29 281–308 Occurrence Handle3042666 Occurrence Handle1:STN:280:DyaL1c3pvVSlsw%3D%3D Occurrence Handle10.1016/S0074-7742(08)60090-2

    Article  PubMed  CAS  Google Scholar 

  • P Walter K Heimann (2000) ArticleTitleEvoked cortical potentials after electrical stimulation of the inner retina in rabbits Graefes Arch Clin Exp Ophthalmol 238 315–318 Occurrence Handle10853930 Occurrence Handle10.1007/s004170050358 Occurrence Handle1:STN:280:DC%2BD3cvitVClsA%3D%3D

    Article  PubMed  CAS  Google Scholar 

  • JD Weiland MS Humayun (2006) ArticleTitleIntraocular retinal prosthesis. Big steps to sight restoration IEEE Eng Med Biol Mag 25 60–66 Occurrence Handle17020200 Occurrence Handle10.1109/MEMB.2006.1705748

    Article  PubMed  Google Scholar 

  • Y Yamauchi LM Franco DJ Jackson JF Naber RO Ziv JF Rizzo HJ Kaplan V Enzmann (2005) ArticleTitleComparison of electrically evoked cortical potential thresholds generated with subretinal or suprachoroidal placement of a microelectrode array in the rabbit J Neural Eng 2 S48–S56 Occurrence Handle15876654 Occurrence Handle10.1088/1741-2560/2/1/007

    Article  PubMed  Google Scholar 

  • E Zrenner (2002) ArticleTitleWill retinal implants restore vision? Science 295 1022–1025 Occurrence Handle11834821 Occurrence Handle10.1126/science.1067996 Occurrence Handle1:CAS:528:DC%2BD38Xht1GksLc%3D

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. School of Medical Sciences, University of New South Wales, Sydney, Australia

    T. Siu & J. Morley

  2. School of Medicine, University of Western Sydney, Sydney, Australia

    J. Morley

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  1. T. Siu
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Correspondence to T. Siu.

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Correspondence: Dr. Timothy Siu, School of Medical Sciences, University of New South Wales, Sydney 2052, Australia.

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Siu, T., Morley, J. Implantation of episcleral electrodes via anterior orbitotomy for stimulation of the retina with induced photoreceptor degeneration: an in vivo feasibility study on a conceptual visual prosthesis. Acta Neurochir (Wien) 150, 477–485 (2008). https://doi.org/10.1007/s00701-008-1528-7

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