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视网膜假体 Argus I 慢性植入的盲患者十年随访。

Ten-Year Follow-up of a Blind Patient Chronically Implanted with Epiretinal Prosthesis Argus I.

机构信息

Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California.

Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, California; Department of Ophthalmology and Visual Sciences, Federal University of São Paulo (UNIFESP), São Paulo, Brazil.

出版信息

Ophthalmology. 2015 Dec;122(12):2545-52.e1. doi: 10.1016/j.ophtha.2015.08.008. Epub 2015 Sep 18.

Abstract

PURPOSE

The Argus I implant is the first-generation epiretinal prosthesis approved for an investigational clinical trial by the United States Food and Drug Administration. Herein we report testing results obtained from a 10-year follow-up to study the physiologic effects of the bioelectronic visual implant after prolonged chronic electrical stimulation.

DESIGN

Case report.

PARTICIPANT

One man, 55 years of age when enrolled in the study, underwent surgical implantation of the Argus I in June 2004, followed by periodic tests from July 2004 through June 2014, spanning a total of 10 years.

METHODS

The decade-long follow-up consisted of implant system performance tests, subject visual function evaluation, and implant-retina interface analysis.

MAIN OUTCOME MEASURES

Changes in electrode impedance and perceptual threshold over the time course; subject's performance on visual function task, orientation, and mobility tests; and optical coherence tomography data, fundus imaging, and fluorescein angiography results for the assessment of subject's implant-retina physical interface.

RESULTS

Electrically elicited phosphenes were present 10 years after implantation of an epiretinal stimulator. The test subject not only was able to perceive phosphenes, but also could perform visual tasks at rates well above chance.

CONCLUSIONS

This decade-long follow-up report provides further support for the use of retinal prostheses as a long-lasting treatment for some types of blindness.

摘要

目的

Argus I 植入物是第一代经美国食品和药物管理局批准进行研究性临床试验的视网膜内假体。在此,我们报告了一项为期 10 年的随访研究结果,旨在研究生物电子视觉植入物在长期慢性电刺激后的生理效应。

设计

病例报告。

参与者

一名 55 岁男性于 2004 年 6 月接受 Argus I 植入手术,随后于 2004 年 7 月至 2014 年 6 月进行定期测试,总随访时间为 10 年。

方法

十年随访包括植入系统性能测试、受试者视觉功能评估和植入物-视网膜界面分析。

主要观察指标

电极阻抗和感知阈值随时间的变化;受试者在视觉功能任务、定向和移动测试中的表现;以及光学相干断层扫描数据、眼底成像和荧光素血管造影结果,用于评估受试者的植入物-视网膜物理界面。

结果

视网膜刺激器植入 10 年后,可诱发出电致光幻视。测试对象不仅能够感知到光幻视,而且能够以远高于随机水平的速度执行视觉任务。

结论

这项长达 10 年的随访报告进一步支持视网膜假体作为某些类型失明的长期治疗方法。

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