Department of Surgery, Division of Ophthalmology, University of Sherbrooke, Sherbrooke, QC J1G 2E8, Canada.
Department of Mechanical and Manufacturing Engineering, University of Calgary, Calgary, AB T2N 1N4, Canada.
Sensors (Basel). 2023 Jun 21;23(13):5782. doi: 10.3390/s23135782.
A retinal prosthesis, also known as a bionic eye, is a device that can be implanted to partially restore vision in patients with retinal diseases that have resulted in the loss of photoreceptors (e.g., age-related macular degeneration and retinitis pigmentosa). Recently, there have been major breakthroughs in retinal prosthesis technology, with the creation of numerous types of implants, including epiretinal, subretinal, and suprachoroidal sensors. These devices can stimulate the remaining cells in the retina with electric signals to create a visual sensation. A literature review of the pre-clinical and clinical studies published between 2017 and 2023 is conducted. This narrative review delves into the retinal anatomy, physiology, pathology, and principles underlying electronic retinal prostheses. Engineering aspects are explored, including electrode-retina alignment, electrode size and material, charge density, resolution limits, spatial selectivity, and bidirectional closed-loop systems. This article also discusses clinical aspects, focusing on safety, adverse events, visual function, outcomes, and the importance of rehabilitation programs. Moreover, there is ongoing debate over whether implantable retinal devices still offer a promising approach for the treatment of retinal diseases, considering the recent emergence of cell-based and gene-based therapies as well as optogenetics. This review compares retinal prostheses with these alternative therapies, providing a balanced perspective on their advantages and limitations. The recent advancements in retinal prosthesis technology are also outlined, emphasizing progress in engineering and the outlook of retinal prostheses. While acknowledging the challenges and complexities of the technology, this article highlights the significant potential of retinal prostheses for vision restoration in individuals with retinal diseases and calls for continued research and development to refine and enhance their performance, ultimately improving patient outcomes and quality of life.
视网膜假体，也称为仿生眼，是一种可以植入的设备，可用于部分恢复因光感受器丧失而导致的视网膜疾病（例如年龄相关性黄斑变性和色素性视网膜炎）患者的视力。最近，视网膜假体技术取得了重大突破，创造了多种类型的植入物，包括视网膜上、视网膜下和脉络膜上传感器。这些设备可以通过电信号刺激视网膜中的剩余细胞，从而产生视觉感。对 2017 年至 2023 年间发表的临床前和临床研究进行文献回顾。本叙述性综述深入探讨了电子视网膜假体的视网膜解剖、生理学、病理学和基本原理。探讨了工程学方面，包括电极-视网膜对齐、电极尺寸和材料、电荷密度、分辨率限制、空间选择性和双向闭环系统。本文还讨论了临床方面，重点关注安全性、不良事件、视觉功能、结果以及康复计划的重要性。此外，鉴于最近细胞和基因疗法以及光遗传学的出现，对于植入式视网膜设备是否仍然为视网膜疾病的治疗提供了有前途的方法，存在争议。本综述将视网膜假体与这些替代疗法进行了比较，对它们的优缺点进行了平衡的评估。还概述了视网膜假体技术的最新进展，强调了工程方面的进展和视网膜假体的前景。虽然承认该技术具有挑战性和复杂性，但本文强调了视网膜假体在恢复视网膜疾病患者视力方面的巨大潜力，并呼吁继续进行研究和开发，以改进和增强其性能，最终改善患者的结果和生活质量。
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