Retinal Prostheses: Engineering and Clinical Perspectives for Vision Restoration

Area of Science:

• Ophthalmology
• Biomedical Engineering
• Neuroscience

Background:

• Retinal diseases like AMD and RP cause photoreceptor loss, leading to blindness.
• Retinal prostheses (bionic eyes) aim to restore partial vision by electrically stimulating remaining retinal cells.
• Recent breakthroughs have led to diverse implantable devices (epiretinal, subretinal, suprachoroidal).

Purpose of the Study:

• To review pre-clinical and clinical studies (2017-2023) on retinal prosthesis technology.
• To explore the engineering principles, clinical outcomes, and safety of retinal implants.
• To compare retinal prostheses with alternative vision restoration therapies like cell- and gene-based treatments.

Main Methods:

• Narrative literature review of studies published between 2017 and 2023.
• Analysis of engineering aspects: electrode design, alignment, charge density, resolution, and closed-loop systems.
• Evaluation of clinical data: safety, adverse events, visual function, outcomes, and rehabilitation.

Main Results:

• Significant advancements in retinal prosthesis engineering and clinical application have been observed.
• Retinal prostheses demonstrate potential for vision restoration, though challenges remain.
• Comparison with cell- and gene-based therapies reveals distinct advantages and limitations for each approach.

Conclusions:

• Retinal prostheses represent a viable, albeit complex, technology for vision restoration in specific retinal diseases.
• Continued research and development are crucial for optimizing performance and patient outcomes.
• The field is evolving, with ongoing debate regarding the optimal therapeutic strategy for vision loss due to photoreceptor degeneration.