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An Electronic Retinal Prosthesis as a Treatment Strategy

John I. Loewenstein, MD; Sandra R. Montezuma, MD; Joseph F. Rizzo III, MD

Arch Ophthalmol. 2004;122:587-596.

Objective  To review progress toward an electronic retinal prosthesis for outer retinal degeneration.

Method  Literature review.

Results  Retinal degenerations such as retinitis pigmentosa result in a loss of photoreceptors. There is a secondary loss of inner retinal cells, but significant numbers of bipolar and ganglion cells remain for many years. Electrical stimulation can produce phosphenes in the eyes of individuals who are blind as a result of retinitis pigmentosa. Several research groups are trying to exploit this phenomenon to produce artificial vision with electronic retinal prostheses. Two groups, with private company sponsorship, have recently implanted first-generation devices in subjects with advanced retinitis pigmentosa. They have reported limited preliminary results. This article seeks to put these results in a broader context and review potential obstacles to successful prosthesis development. These include inner retinal cell viability, high thresholds, signal encoding, power requirements, biocompatibility, and device encapsulation.

Conclusion  There has been substantial progress toward an electronic retinal prosthesis, but fully functional, long-lasting devices are not on the immediate horizon.

From the Massachusetts Eye and Ear Infirmary, Boston, Mass (Drs Loewenstein, Montezuma, and Rizzo), and the Veterans' Administration Center for Innovative Rehabilitation, Boston (Dr Rizzo). The authors have no relevant financial interest in this article.

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