Humayun M, Propst R, de Juan E, McCormick K, Hickingbotham D
Duke University Eye Center, Durham, NC.
Arch Ophthalmol. 1994 Jan;112(1):110-6. doi: 10.1001/archopht.1994.01090130120028.
Retinitis pigmentosa with attendant photoreceptor loss can cause a profound visual handicap. We have postulated that an intraocular prosthesis that could electrically stimulate the inner retina might provide vision to some of these patients. For such a prosthesis to be feasible, electrical stimulation of the inner retina must elicit a focal retinal response. The stimulating current densities required to elicit such a response must not result in irreversible toxic reactions at the electrode-tissue interface.
To test the feasibility of this approach, we used bipolar platinum wire electrodes to electrically stimulate the inner retinal surface in bullfrog eyecup preparations and, using similar methods, we electrically stimulated rabbit eyes after injecting intravenous sodium iodate (40 mg/kg), a retinal pigment epithelial toxin with secondary effects on the photoreceptors.
Surface electrical stimulation of the inner retina in normal eyes and in eyes with outer retinal degeneration can elicit a localized retinal response. The threshold stimulating currents resulted in charge densities of 2.98 microcoulombs per square centimeter (bullfrog), 8.92 microC/cm2 (normal rabbit), and 11.9 microC/cm2 (rabbit retinas with outer retinal degenerations). These charge densities are within the previously delineated safe limits for long-term electrical stimulation of neural tissue using platinum microelectrodes (100 microC/cm2).
Multifocal electrical stimulation of the retina might be a viable approach to provide some vision to patients who have profound visual loss due to outer retinal degenerations.
伴有光感受器丧失的视网膜色素变性可导致严重的视力障碍。我们推测,一种能够电刺激视网膜内层的眼内假体可能为部分此类患者提供视力。要使这种假体可行,对视网膜内层的电刺激必须引发局灶性视网膜反应。引发这种反应所需的刺激电流密度不能在电极 - 组织界面导致不可逆的毒性反应。
为了测试这种方法的可行性,我们使用双极铂丝电极对牛蛙眼杯标本的视网膜内层表面进行电刺激,并且采用类似方法,在静脉注射碘酸钠(40毫克/千克)后对兔眼进行电刺激,碘酸钠是一种对光感受器有继发作用的视网膜色素上皮毒素。
对正常眼和视网膜外层变性眼的视网膜内层进行表面电刺激可引发局部视网膜反应。阈值刺激电流产生的电荷密度在牛蛙中为每平方厘米2.98微库仑,在正常兔中为8.92微库仑/平方厘米,在视网膜外层变性的兔视网膜中为11.9微库仑/平方厘米。这些电荷密度在先前划定的使用铂微电极对神经组织进行长期电刺激的安全限度(100微库仑/平方厘米)之内。
对视网膜进行多焦点电刺激可能是一种可行的方法,可为因视网膜外层变性而严重视力丧失的患者提供一定视力。