Hadjinicolaou Alex E, Meffin Hamish, Maturana Matias I, Cloherty Shaun L, Ibbotson Michael R
National Vision Research Institute, Australian College of Optometry, Carlton, Victoria, Australia.
ARC Centre of Excellence for Integrative Brain Function and Department of Optometry and Vision Sciences, University of Melbourne, Parkville, Victoria, Australia.
Clin Exp Optom. 2015 Sep;98(5):395-410. doi: 10.1111/cxo.12342.
Retinal disease and its associated retinal degeneration can lead to the loss of photoreceptors and therefore, profound blindness. While retinal degeneration destroys the photoreceptors, the neural circuits that convey information from the eye to the brain are sufficiently preserved to make it possible to restore sight using prosthetic devices. Typically, these devices consist of a digital camera and an implantable neurostimulator. The image sensor in a digital camera has the same spatiotopic arrangement as the photoreceptors of the retina. Therefore, it is possible to extract meaningful spatial information from an image and deliver it via an array of stimulating electrodes directly to the surviving retinal circuits. Here, we review the structure and function of normal and degenerate retina. The different approaches to prosthetic implant design are described in the context of human and preclinical trials. In the last section, we review studies of electrical properties of the retina and its response to electrical stimulation. These types of investigation are currently assessing a number of key challenges identified in human trials, including stimulation efficacy, spatial localisation, desensitisation to repetitive stimulation and selective activation of retinal cell populations.
视网膜疾病及其相关的视网膜变性可导致光感受器丧失，进而导致严重失明。虽然视网膜变性会破坏光感受器，但从眼睛向大脑传递信息的神经回路仍能得到充分保留，这使得使用假体装置恢复视力成为可能。通常，这些装置由数码相机和植入式神经刺激器组成。数码相机中的图像传感器与视网膜的光感受器具有相同的空间布局。因此，有可能从图像中提取有意义的空间信息，并通过一系列刺激电极直接将其传递给存活的视网膜回路。在此，我们综述正常和退化视网膜的结构与功能。在人体试验和临床前试验的背景下描述了假体植入设计的不同方法。在最后一部分，我们综述了关于视网膜电特性及其对电刺激反应的研究。这些类型的研究目前正在评估人体试验中发现的一些关键挑战，包括刺激效果、空间定位、对重复刺激的脱敏以及视网膜细胞群体的选择性激活。
