Neurosurgery, Ophthalmology and Hansen Experimental Physics Laboratory, Stanford University, Stanford, CA 94305, United States of America.
J Neural Eng. 2019 Apr;16(2):025003. doi: 10.1088/1741-2552/aaf270. Epub 2018 Nov 20.
The nature of artificial vision with a retinal prosthesis, and the degree to which the brain can adapt to the unnatural input from such a device, are poorly understood. Therefore, the development of current and future devices may be aided by theory and simulations that help to infer and understand what prosthesis patients see.
A biologically-informed, extensible computational framework is presented here to predict visual perception and the potential effect of learning with a subretinal prosthesis. The framework relies on optimal linear reconstruction of the stimulus from retinal responses to infer the visual information available to the patient. A simulation of the physiological optics of the eye and light responses of the major retinal neurons was used to calculate the optimal linear transformation for reconstructing natural images from retinal activity. The result was then used to reconstruct the visual stimulus during the artificial activation expected from a subretinal prosthesis in a degenerated retina, as a proxy for inferred visual perception.
Several simple observations reveal the potential utility of such a simulation framework. The inferred perception obtained with prosthesis activation was substantially degraded compared to the inferred perception obtained with normal retinal responses, as expected given the limited resolution and lack of cell type specificity of the prosthesis. Consistent with clinical findings and the importance of cell type specificity, reconstruction using only ON cells, and not OFF cells, was substantially more accurate. Finally, when reconstruction was re-optimized for prosthesis stimulation, simulating the greatest potential for learning by the patient, the accuracy of inferred perception was much closer to that of healthy vision.
The reconstruction approach thus provides a more complete method for exploring the potential for treating blindness with retinal prostheses than has been available previously. It may also be useful for interpreting patient data in clinical trials, and for improving prosthesis design.
视网膜假体所带来的人工视觉的本质,以及大脑适应这种设备所带来的非自然输入的程度,这些都还没有被很好地理解。因此,当前和未来设备的开发可以借助于理论和模拟来帮助推断和理解假体患者所看到的内容。
本文提出了一种基于生物信息学的可扩展计算框架,用于预测使用视网膜下假体的视觉感知和潜在学习效果。该框架依赖于从视网膜反应中对刺激进行最佳线性重建,以推断出患者可获得的视觉信息。模拟眼睛的生理光学和主要视网膜神经元的光反应,用于从视网膜活动中计算重建自然图像的最佳线性变换。然后,将结果用于在退化的视网膜中模拟来自视网膜下假体的人工激活时重建视觉刺激,作为推断视觉感知的代理。
几个简单的观察结果揭示了这种模拟框架的潜在效用。与正常视网膜反应获得的推断感知相比,假体激活获得的推断感知明显下降,这与假体的有限分辨率和缺乏细胞类型特异性一致。与临床发现和细胞类型特异性的重要性一致,仅使用 ON 细胞而不是 OFF 细胞进行重建的准确性要高得多。最后,当重新优化用于假体刺激的重建以模拟患者最大的学习潜力时,推断感知的准确性与健康视力更接近。
因此,这种重建方法为使用视网膜假体治疗失明提供了比以前更完整的方法。它也可能有助于解释临床试验中的患者数据,并改进假体设计。