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      Subretinal electronic chips allow blind patients to read letters and combine them to words

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          Abstract

          A light-sensitive, externally powered microchip was surgically implanted subretinally near the macular region of volunteers blind from hereditary retinal dystrophy. The implant contains an array of 1500 active microphotodiodes (‘chip’), each with its own amplifier and local stimulation electrode. At the implant's tip, another array of 16 wire-connected electrodes allows light-independent direct stimulation and testing of the neuron–electrode interface. Visual scenes are projected naturally through the eye's lens onto the chip under the transparent retina. The chip generates a corresponding pattern of 38 × 40 pixels, each releasing light-intensity-dependent electric stimulation pulses. Subsequently, three previously blind persons could locate bright objects on a dark table, two of whom could discern grating patterns. One of these patients was able to correctly describe and name objects like a fork or knife on a table, geometric patterns, different kinds of fruit and discern shades of grey with only 15 per cent contrast. Without a training period, the regained visual functions enabled him to localize and approach persons in a room freely and to read large letters as complete words after several years of blindness. These results demonstrate for the first time that subretinal micro-electrode arrays with 1500 photodiodes can create detailed meaningful visual perception in previously blind individuals.

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          Most cited references36

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          Causes and prevalence of visual impairment among adults in the United States.

          To estimate the cause-specific prevalence and distribution of blindness and low vision in the United States by age, race/ethnicity, and gender, and to estimate the change in these prevalence figures over the next 20 years. Summary prevalence estimates of blindness (both according to the US definition of < or =6/60 [< or =20/200] best-corrected visual acuity in the better-seeing eye and the World Health Organization standard of < 6/120 [< 20/400]) and low vision (< 6/12 [< 20/40] best-corrected vision in the better-seeing eye) were prepared separately for black, Hispanic, and white persons in 5-year age intervals starting at 40 years. The estimated prevalences were based on recent population-based studies in the United States, Australia, and Europe. These estimates were applied to 2000 US Census data, and to projected US population figures for 2020, to estimate the number of Americans with visual impairment. Cause-specific prevalences of blindness and low vision were also estimated for the different racial/ethnic groups. Based on demographics from the 2000 US Census, an estimated 937 000 (0.78%) Americans older than 40 years were blind (US definition). An additional 2.4 million Americans (1.98%) had low vision. The leading cause of blindness among white persons was age-related macular degeneration (54.4% of the cases), while among black persons, cataract and glaucoma accounted for more than 60% of blindness. Cataract was the leading cause of low vision, responsible for approximately 50% of bilateral vision worse than 6/12 (20/40) among white, black, and Hispanic persons. The number of blind persons in the US is projected to increase by 70% to 1.6 million by 2020, with a similar rise projected for low vision. Blindness or low vision affects approximately 1 in 28 Americans older than 40 years. The specific causes of visual impairment, and especially blindness, vary greatly by race/ethnicity. The prevalence of visual disabilities will increase markedly during the next 20 years, owing largely to the aging of the US population.
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            Will retinal implants restore vision?

            A number of research groups are developing electrical implants that can be attached directly to the retina in an attempt to restore vision to patients suffering from retinal degeneration. However, despite promising results in animal experiments, there are still several major obstacles to overcome before retinal prostheses can be used clinically.
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              Retinal remodeling during retinal degeneration.

              Retinal degenerations, regardless of the initiating event or gene defect, often result in a loss of photoreceptors. This formal deafferentation of the neural retina eliminates the intrinsic glutamatergic drive of the sensory retina and, perhaps more importantly, removes coordinated Ca++-coupled signaling to the neural retina. As in other central nervous system degenerations, deafferentation activates remodeling. Neuronal remodeling is the common fate of all photoreceptor degenerations.
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                Author and article information

                Journal
                Proc Biol Sci
                RSPB
                royprsb
                Proceedings of the Royal Society B: Biological Sciences
                The Royal Society
                0962-8452
                1471-2954
                22 May 2011
                3 November 2010
                3 November 2010
                : 278
                : 1711
                : 1489-1497
                Affiliations
                [1 ]Centre for Ophthalmology, simpleUniversity of Tübingen , Schleichstr. 12, 72076 Tübingen, Germany
                [2 ]simpleEye Clinic, University of Regensburg , Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
                [3 ]Retina Implant AG, Gerhard-Kindler-Str. 8, 72770 Reutlingen, Germany
                [4 ]Department of Ophthalmology, Semmelweis University, Tomo u. 25-29, 1083 Budapest, Hungary
                [5 ]Steinbeis Transfer Centre Eyetrial at the Centre for Ophthalmology, Schleichstr. 12-16, 72076 Tübingen, Germany
                [6 ]Klinikum Friedrichstadt, Friedrichstr. 41, 01067 Dresden, Germany
                [7 ]simpleNMI Natural and Medical Sciences Institute at the University of Tübingen , Markwiesenstr. 55, 72770 Reutlingen, Germany
                Author notes
                [* ]Author for correspondence ( ezrenner@ 123456uni-tuebingen.de ).
                Article
                rspb20101747
                10.1098/rspb.2010.1747
                3081743
                21047851
                8488e71f-de06-41f6-aaeb-0657f311f45c
                This Journal is © 2010 The Royal Society

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 24 August 2010
                : 13 October 2010
                Categories
                1001
                18
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                133
                Research Articles

                Life sciences
                retinal implant,retinitis pigmentosa,artificial vision,subretinal neuro-prosthetics,bionic vision,blindness

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