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Article
Daniel Palanker
Stanford University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-0480-3025
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This work is licensed under a CC BY 4.0 License. Read Full License
Loss of photoreceptors in atrophic age-related macular degeneration (AMD) results in severe visual impairment. Since the low-resolution peripheral vision is retained in such conditions, restoration of central vision should not jeopardize the surrounding healthy retina and allow for simultaneous use of the natural and prosthetic sight. We report the first clinical results with a photovoltaic substitute of photoreceptors providing simultaneous use of the central prosthetic and peripheral natural vision in atrophic AMD. Four patients with geographic atrophy have been implanted subretinally with a wireless 2x2mm-wide 30 µm-thick device, having 378 pixels of 100 µm in size. They demonstrated Landolt acuity of 1.17 ± 0.13 pixels, corresponding to the Snellen range of 20/460–20/565. With electronic magnification of up to a factor of 8, patients demonstrated acuity in the range of 20/63 − 20/98. Under room lighting conditions, patients could simultaneously use prosthetic central vision and their remaining peripheral vision in the implanted eye and in the fellow eye.
Keywords
age-related macular degeneration, photoreceptors, prosthetic and natural vision, simultaneous perception
Figure 1
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This is a list of supplementary files associated with this preprint. Click to download.
- VideoS1ETDRSanonym.mp4
Video S1. Letter acuity test on ETDRS chart using PRIMA-2 glasses at x4 magnification and a contrast reversal.
- VideoS2Readingshortanonym.mp4
Video S2. Reading test with PRIMA-2 glasses at x4 magnification and a contrast reversal.
- VideoS3Readingnaturalcontrolanonym.mp4
Video S3. Control experiment for reading the same word as in S2, but without PRIMA-2 glasses.
- VideoS4simultaneousbinocularanonym.mp4
Video S4. Simultaneous detection of the bars using prosthetic and natural vision in both eyes.
- VideoS5simultaneousmonocularanonym.mp4
Video S5. Simultaneous detection of the bars using prosthetic and natural vision in the same eye.
- PRIMAclinicalprotocolmainpartRev320190619.pdf
PRIMA_clinical_protocol
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This preprint is under consideration at a Nature Portfolio Journal. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Nature journals have partnered with Research Square to offer In Review, a journal-integrated preprint deposition service.
Article
Daniel Palanker
Stanford University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-0480-3025
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 26 Mar, 2021
Subject Areas
Ophthalmology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Loss of photoreceptors in atrophic age-related macular degeneration (AMD) results in severe visual impairment. Since the low-resolution peripheral vision is retained in such conditions, restoration of central vision should not jeopardize the surrounding healthy retina and allow for simultaneous use of the natural and prosthetic sight. We report the first clinical results with a photovoltaic substitute of photoreceptors providing simultaneous use of the central prosthetic and peripheral natural vision in atrophic AMD. Four patients with geographic atrophy have been implanted subretinally with a wireless 2x2mm-wide 30 µm-thick device, having 378 pixels of 100 µm in size. They demonstrated Landolt acuity of 1.17 ± 0.13 pixels, corresponding to the Snellen range of 20/460–20/565. With electronic magnification of up to a factor of 8, patients demonstrated acuity in the range of 20/63 − 20/98. Under room lighting conditions, patients could simultaneously use prosthetic central vision and their remaining peripheral vision in the implanted eye and in the fellow eye.
Figure 1
Figure 2
Figure 3
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