RSS-Feed abonnieren
DOI: 10.1055/s-0028-1109078
© Georg Thieme Verlag KG Stuttgart · New York
Künstliches Sehen: Stand der Entwicklung
Artificial Sight: Recent DevelopmentsPublikationsverlauf
Eingegangen: 12.10.2008
Angenommen: 12.11.2008
Publikationsdatum:
17. März 2009 (online)
![](https://www.thieme-connect.de/media/klimo/200903/lookinside/thumbnails/10.1055-s-0028-1109078-1.jpg)
Zusammenfassung
Die Implantation elektronischer Netzhautstimulatoren wird künftig eine Möglichkeit sein, bei Patienten, die aufgrund einer degenerativen Netzhauterkrankung erblindet sind, die Sehfähigkeit partiell wieder herzustellen. Die Idee solcher Sehprothesen ist nicht neu, sie scheint aber aufgrund des allgemeinen technischen Fortschritts nun realisierbar zu werden. Sehprothesen können an jeder Stelle des visuellen Systems integriert werden. So gibt es subretinale und epiretinale Netzhautstimulatoren sowie Stimulatoren, die direkt mit dem Sehnerv verbunden werden. Auch Versuche einer direkten Stimulation der Sehrinde sind unternommen worden. Mehrere große Konsortien verfolgen momentan die epiretinale Stimulation. Grundsätzlich bleibt das große Problem der Signalmodulation zu lösen, sodass über den Stimulator dem Gehirn eine interpretierbare Sehinformation zur Verfügung gestellt wird. Der Artikel fasst unter Berücksichtigung aktueller Beiträge die gegenwärtigen Konzepte zusammen.
Abstract
The implantation of electronic retina stimulators appears to be a future possibility to restore vision, at least partially in patients with retinal degeneration. The idea of such visual protheses is not new but due to the general technical progress it has become more likely that a functioning implant will be on the market soon. Visual prosthesis may be integrated in the visual system in various places. Thus there are subretinal and epiretinal implants, as well as implants that are connected directly to the optic nerve or the visual cortex. The epiretinal approach is the most promising at the moment, but the problem of appropriate modulation of the image information is unsolved so far. This will be necessary to provide a interpretable visual information to the brain. The present article summarises the concepts and includes some latest information from recent conferences.
Schlüsselwörter
Retina - Informationstechnologie - Elektrophysiologie
Key words
retina - information technology - electrophysiology
Literatur
- 1 Brelen M E, De Potter P, Gersdorff M. et al . Intraorbital implantation of a stimulating electrode for an optic nerve visual prosthesis. Case report. J Neurosurg. 2006; 104 593-597
- 2 Chow A Y, Chow V Y. Subretinal electrical stimulation of the rabbit retina. Neuroscience letters. 1997; 225 13-16
- 3 Chow A Y, Chow V Y, Packo K H. et al . The artificial silicon retina microchip for the treatment of vision loss from retinitis pigmentosa. Archives of ophthalmology. 2004; 122 460-469
- 4 Chow A Y, Pardue M T, Perlman J I. et al . Subretinal implantation of semiconductor-based photodiodes: durability of novel implant designs. Journal of rehabilitation research and development. 2002; 39 313-321
- 5 Dobelle W H. Artificial vision for the blind by connecting a television camera to the visual cortex. Asaio J. 2000; 46 3-9
- 6 Eckmiller R. Learning retina implants with epiretinal contacts. Ophthalmic research. 1997; 29 281-289
- 7 Eckmiller R, Borbe S. Selective Tuning of Temporal Pattern Presentation and Electrode Stimulation in a Retinal Implant. Investigative ophthalmology & visual science. 2008; 49 E-Abstract 5875
- 8 Eckmiller R, Neumann D, Baruth O. Tunable retina encoders for retina implants: why and how. Journal of neural engineering. 2005; 2 S91-S104
- 9 Feucht M, Laube T, Bornfeld N. et al . Development of an epiretinal prosthesis for stimulation of the human retina. Ophthalmologe. 2005; 102 688-691
- 10 Fried S I, Lasker A C, Eddington D K. et al . Two Different Parts of the Ganglion Cell Axon Are Activated by Epi-Retinal Electrical Stimulation. Investigative ophthalmology & visual science. 2008; 49 E-Abstract 3034
- 11 Gerding H. A new approach towards a minimal invasive retina implant. Journal of neural engineering. 2007; 4 S30-37
- 12 Humayun M, Propst R, Juan de E. et al . Bipolar surface electrical stimulation of the vertebrate retina. Archives of ophthalmology. 1994; 112 110-116
- 13 Humayun M S, Juan de E, Dagnelie Jr G. et al . Visual perception elicited by electrical stimulation of retina in blind humans. Archives of ophthalmology. 1996; 114 40-46
- 14 Javaheri M, Hahn Jr D S, Lakhanpal R R. et al . Retinal prostheses for the blind. Annals of the Academy of Medicine. 2006; 35 137-144
- 15 Keserü M, Feucht M, Post N. et al . Clinical Study in Chronic Electrical Stimulation of Human Retina With an Epiretinal Electrode Array: Fluorescein Angiography and OCT Findings. Investigative ophthalmology & visual science. 2008; 49 E-Abstract 1785
- 16 Knauer C, Pfeiffer N. Blindness in Germany – today and in 2030. Ophthalmologe. 2006; 103 735-741
- 17 LeRoy C. Oú l’on rend compte de quelques tentatives que l’on faites pour guérir plusieurs maladies par l’électricité. Mémoires Math Phys Paris; Hist Acad Roy Sciences 1755: 87-95
- 18 Loudin J D, Palanker D. Photovoltaic Retinal Prosthesis. Investigative ophthalmology & visual science. 2008; 49 E-Abstract 3014
- 19 Maynard E M, Nordhausen C T, Normann R A. The Utah intracortical Electrode Array: a recording structure for potential brain-computer interfaces. Electroencephalography and clinical neurophysiology. 1997; 102 228-239
- 20 Pardue M T, Phillips M J, Yin H. et al . Possible sources of neuroprotection following subretinal silicon chip implantation in RCS rats. Journal of neural engineering. 2005; 2 S39-S47
- 21 Pardue M T, Phillips M J, Yin H. et al . Neuroprotective effect of subretinal implants in the RCS rat. Investigative ophthalmology & visual science. 2005; 46 674-682
- 22 Ren Q, Chai X, Wu K. et al .Visual Prosthesis Based on Optic Never Stimulation with Penetrating Electrode Array. Humayun MS, Weiland JD, Chader G, Greenbaum E Artifical Sight New York; Springer 2007: 187-207
- 23 Richard G, Keserü M, Feucht M. et al . Visual Perceptions After Long-Term Implantation of a Retinal Implant. Investigative ophthalmology & visual science. 2008; 49 E-Abstract 1786
- 24 Sachs H G, Schanze T, Wilms M. et al . Subretinal implantation and testing of polyimide film electrodes in cats. Graefe’s archive for clinical and experimental ophthalmology=Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie. 2005; 243 464-468
- 25 Schanze T, Sachs H G, Wiesenack C. et al . Implantation and testing of subretinal film electrodes in domestic pigs. Experimental eye research. 2006; 82 332-340
- 26 Shah S, Hines A, Zhou D. et al . Electrical properties of retinal-electrode interface. Journal of neural engineering. 2007; 4 S24-S29
- 27 Sommerhalder J R, Perez Fornoz A, Safran A B. et al . Reading With a Simulated 60-Channel Retinal Implant. Investigative ophthalmology & visual science. 2008; 49 E-Abstract 3012
- 28 Troyk P R, Bradley D, Bak M. et al . Intracortical visual prosthesis research – approach and progress. Conf Proc IEEE Eng Med Biol Soc. 2005; 7 7376-7379
- 29 Uhlig C E, Taneri S, Benner F P. et al . Electrical stimulation of the visual system. From empirical approach to visual prostheses. Ophthalmologe. 2001; 98 1089-1096
- 30 Veraart C, Raftopoulos C, Mortimer J T. et al . Visual sensations produced by optic nerve stimulation using an implanted self-sizing spiral cuff electrode. Brain research. 1998; 813 181-186
- 31 Walter P, Mokwa W, Messner A. The EPIRET3 Wireless Intraocular Retina Implant System: Design of the EPIRET3 Prospective Clinical Trial and Overview. Investigative ophthalmology & visual science. 2008; 49 E-Abstract 3023
- 32 Warren D J, Normann R A. Visula Neuroprostheses. Finn WE, LoPresti GP Handbook of Neuroprosthetic Methods Boca Raton; CRC Press 2003: 261-305
- 33 Yanai D, Weiland J D, Mahadevappa M. et al . Visual performance using a retinal prosthesis in three subjects with retinitis pigmentosa. American journal of ophthalmology. 2007; 143 820-827
- 34 Zrenner E, Wilke R, Zabel T. et al . Psychometric Analysis of Visual Sensations Mediated by Subretinal Arrays Implanted Into Blind Retinitis Pigmentosa Patients. Investigative ophthalmology & visual science. 2006; 48 E-Abstract 659
PD Dr. Oliver Zeitz
Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg-Eppendorf
Martinistr. 52
20246 Hamburg
Telefon: ++ 49/40/4 28 03 33 14
Fax: ++ 49/40/4 28 03 88 84
eMail: zeitz@uke.uni-hamburg.de