Vision Restoration
vision restoration
Restoring Sight to the Blind: Effects of Structural and Functional Plasticity
Visual restoration after decades of blindness is now becoming possible by means of retinal and cortical prostheses, as well as emerging stem cell and gene therapeutic approaches. After restoring visual perception, however, a key question remains. Are there optimal means and methods for retraining the visual cortex to process visual inputs, and for learning or relearning to “see”? Up to this point, it has been largely assumed that if the sensory loss is visual, then the rehabilitation focus should also be primarily visual. However, the other senses play a key role in visual rehabilitation due to the plastic repurposing of visual cortex during blindness by audition and somatosensation, and also to the reintegration of restored vision with the other senses. I will present multisensory neuroimaging results, cortical thickness changes, as well as behavioral outcomes for patients with Retinitis Pigmentosa (RP), which causes blindness by destroying photoreceptors in the retina. These patients have had their vision partially restored by the implantation of a retinal prosthesis, which electrically stimulates still viable retinal ganglion cells in the eye. Our multisensory and structural neuroimaging and behavioral results suggest a new, holistic concept of visual rehabilitation that leverages rather than neglects audition, somatosensation, and other sensory modalities.
An inconvenient truth: pathophysiological remodeling of the inner retina in photoreceptor degeneration
Photoreceptor loss is the primary cause behind vision impairment and blindness in diseases such as retinitis pigmentosa and age-related macular degeneration. However, the death of rods and cones allows retinoids to permeate the inner retina, causing retinal ganglion cells to become spontaneously hyperactive, severely reducing the signal-to-noise ratio, and creating interference in the communication between the surviving retina and the brain. Treatments aimed at blocking or reducing hyperactivity improve vision initiated from surviving photoreceptors and could enhance the signal fidelity generated by vision restoration methodologies.
Gene therapy for Optic Neuropathies
Assessing and improving vision restoration using ex vivo retina
On the acquisition of visual functions following early-onset and prolonged visual deprivation
Toward a High-fidelity Artificial Retina for Vision Restoration
Electronic interfaces to the retina represent an exciting development in science, engineering, and medicine – an opportunity to exploit our knowledge of neural circuitry and function to restore or even enhance vision. However, although existing devices demonstrate proof of principle in treating incurable blindness, they produce limited visual function. Some of the reasons for this can be understood based on the precise and specific neural circuitry that mediates visual signaling in the retina. Consideration of this circuitry suggests that future devices may need to operate at single-cell, single-spike resolution in order to mediate naturalistic visual function. I will show large-scale multi-electrode recording and stimulation data from the primate retina indicating that, in some cases, such resolution is possible. I will also discuss cases in which it fails, and propose that we can improve artificial vision in such conditions by incorporating our knowledge of the visual system in bi-directional devices that adapt to the host neural circuitry. Finally, I will introduce the Stanford Artificial Retina Project, aimed at developing a retinal implant that more faithfully reproduces the neural code of the retina, and briefly discuss the implications for scientific investigation and for other neural interfaces of the future.
REST as a target for vision restoration
FENS Forum 2024