July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Development of a Cortical Visual Neuroprosthesis for the Blind: Preliminary results
Author Affiliations & Notes
  • Eduardo Fernandez
    Instituto de Bioingenieria, Univ of Miguel Hernandez, Elche, ALICANTE, Spain
    John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, United States
  • Cristina Soto
    Instituto de Bioingenieria, Univ of Miguel Hernandez, Elche, ALICANTE, Spain
  • Arantxa Alfaro
    Instituto de Bioingenieria, Univ of Miguel Hernandez, Elche, ALICANTE, Spain
  • Pablo Gonzalez
    Instituto de Bioingenieria, Univ of Miguel Hernandez, Elche, ALICANTE, Spain
  • Antonio Lozano
    Instituto de Bioingenieria, Univ of Miguel Hernandez, Elche, ALICANTE, Spain
  • Sebastian Peña
    Instituto de Bioingenieria, Univ of Miguel Hernandez, Elche, ALICANTE, Spain
  • Maria Dolores Grima
    Instituto de Bioingenieria, Univ of Miguel Hernandez, Elche, ALICANTE, Spain
  • Alfonso Rodil
    Instituto de Bioingenieria, Univ of Miguel Hernandez, Elche, ALICANTE, Spain
  • Antonio Alarcon
    Instituto de Bioingenieria, Univ of Miguel Hernandez, Elche, ALICANTE, Spain
  • John Rolston
    John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, United States
  • Tyler Davies
    John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, United States
  • Richard A Normann
    John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, United States
  • Footnotes
    Commercial Relationships   Eduardo Fernandez, None; Cristina Soto, None; Arantxa Alfaro, None; Pablo Gonzalez, None; Antonio Lozano, None; Sebastian Peña, None; Maria Dolores Grima, None; Alfonso Rodil, None; Antonio Alarcon, None; John Rolston, None; Tyler Davies, None; Richard Normann, None
  • Footnotes
    Support  This work was supported in part by Grant No. MAT2015-69967-C3-1-R from the Spanish Government, by the Bidons Egara Research Chair and by the National Organization of the Spanish Blind (ONCE).
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 4021. doi:
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      Eduardo Fernandez, Cristina Soto, Arantxa Alfaro, Pablo Gonzalez, Antonio Lozano, Sebastian Peña, Maria Dolores Grima, Alfonso Rodil, Antonio Alarcon, John Rolston, Tyler Davies, Richard A Normann; Development of a Cortical Visual Neuroprosthesis for the Blind: Preliminary results. Invest. Ophthalmol. Vis. Sci. 2019;60(9):4021.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Visual prostheses are implantable medical devices that are able to provide some degree of useful vision to individuals who are functionally blind. Retinal prostheses have been the most successful approach to date and several visual prostheses systems have been already approved to treat some eye diseases. However, this approach is not suitable for pathologies affecting the entire retina, optic nerve or thalamus. We are facing the challenge of creating an intracortical visual neuroprosthesis designed to interface with the occipital cortex as a means through which a limited but useful visual sense could be restored to these blind patients.

Methods : We are performing a Clinical Trial (Identifier: NCT02983370) to evaluate the usefulness of a cortical visual prosthesis based on intracortical microelectrodes. The first blind volunteer has been already implanted with our existing system, which utilizes a Utah Electrode Array (UEA). The UEA was implanted in the right visual cortex, near the occipital pole (O1). We are collecting multielectrode recordings and descriptive feedback regarding thresholds, the main features of evoked perceptions and stimulation parameters. Customized programs allowed easy registration and analysis of collected data.

Results : Our results demonstrate that the implantation can be done without major complications and that high-quality recordings from visually deprived neurons can be consistently obtained. Thresholds currents for phosphene generation with biphasic pulses were as low as 1 mA, and most electrodes had thresholds below 16 mA. The most common perceptions consisted of elementary visual images described as lines and flashing dots. The size of the perceived phosphenes ranged from a “pin-point” to almost half visual field, depending on the location of the electrode and stimulation parameters. No other symptoms such as seizures, nausea, or neurological deficits occurred during or after stimulation. No adverse effects have been reported to date.

Conclusions : The results of this study, although very preliminary, are very encouraging in terms of the feasibility of a cortical visual prosthesis. While the full restorations of vision seem to be unlikely in the near future, a cortical device based on intracortical microelectrodes could be able to create meaningful visual perceptions. However, there are still a number of relevant open questions and more experiments should be done.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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