Suprachoroidal Retinal Prostheses

Visual prostheses are currently being developed by a number of international teams for the restoration of basic visual function to those with profound vision impairment or blindness. In this exciting field of research and development, a number of unique d

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Suprachoroidal Retinal Prostheses Lauren N. Ayton, Gregg J. Suaning, Nigel H. Lovell, Matthew A. Petoe, David A.X. Nayagam, Tamara-Leigh E. Brawn, and Anthony N. Burkitt

Abstract Visual prostheses are currently being developed by a number of international teams for the restoration of basic visual function to those with profound vision impairment or blindness. In this exciting field of research and development, a number of unique device designs and surgical placements have been developed. This chapter discusses the engineering specifications, preclinical testing and clinical trial outcomes for suprachoroidal prostheses. These implants are placed between the posterior blood supply of the eye (choroid) and the outer white layer of the eye (sclera), with this surgical location primarily being chosen for stability and safety. In the pilot study of a prototype suprachoroidal implant, which was held in Australia between 2012 and 2014, there were no unexpected intraocular serious adverse events in the three implanted participants. Future trials will examine safety and efficacy of implants with larger numbers of electrodes in larger cohorts of participants with profound vision loss from retinitis pigmentosa. It is also hoped that in the future suprachoroidal prostheses may be able to be used in people with some residual vision (such as in age-related macular degeneration).

L.N. Ayton, PhD, B.Optom, FAAO, FACO (*) Centre for Eye Research Australia, The University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, Australia e-mail: [email protected] G.J. Suaning, BSc, MSc, PhD • N.H. Lovell, BE (Hons), PhD Graduate School of Biomedical Engineering, University of New South Wales, Sydney, NSW, Australia M.A. Petoe, BSc, BEng (Hons), PhD • D.A.X. Nayagam, BSc, BE(ElecEng)(Hons), PhD Bionics Institute, The University of Melbourne, Melbourne, VIC, Australia T.-L. E. Brawn, BA, BBSc, PostGradDip Ed, MBA Bionic Vision Australia, University of Melbourne, Parkville, VIC, Australia A.N. Burkitt, PhD, BSc (Hon), BSc Department of Electrical and Electronic Engineering, The University of Melbourne, Melbourne, VIC, Australia © Springer International Publishing Switzerland 2017 V.P. Gabel (ed.), Artificial Vision, DOI 10.1007/978-3-319-41876-6_10

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The work described in this chapter, conducted by the Bionic Vision Australia (BVA) consortium, deals exclusively with suprachoroidal implantation of a stimulating array. Data are presented from the surgical implantation and psychophysical responses of a 24-channel percutaneously connected prototype device implanted in three subjects. The architecture of two future-generation fully-implantable suprachoroidal prostheses, a 44-channel device and the 99-channel ‘Phoenix’ device are also presented. Keywords Suprachoroidal • Retinal stimulation • Retinal prosthesis • Vision restoration • Retinitis pigmentosa • Medical bionics

Key Points • Suprachoroidal retinal prostheses are placed in the suprachoroidal space, between the sclera and the choroi