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Bionic eye provides hope for rare disease

AGENCE FRANCE PRESSE Saturday 16 February 2013 Last Update 15 February 2013 11:25 pm WASHINGTON: US regulators approved a so-called bionic eye on Thursday, giving hope to people with a rare genetic disease. Developed by California-based Second Sight Medical Products, Inc., the Argus II Retinal Prosthesis System is the first retinal implant for adults with advanced retinitis pigmentosa that results in the gradual loss of vision and can lead to blindness. While the Argus II Retinal Prosthesis System will not restore vision to patients, it may allow them to detect light and dark in the environment, aiding them in identifying the location or movement of objects or people, the US Food and Drug Administration said in a statement announcing its decision. The device includes a small video camera and a transmitter mounted on a pair of glasses, as well as a video processing unit and an implanted retinal prosthesis that replaces the function of degenerated cells in the retina. This new surgically implanted assistive device provides an option for patients who have lost their sight to RP (retinitis pigmentosa), for whom there have been no FDA-approved treatments, said Jeffrey Shuren, FDA director. The device may help adults with RP who have lost the ability to perceive shapes and movement to be more mobile and to perform day-to-day activities. Already greenlighted by European regulators, the FDA approved the Argus II as a humanitarian use device, which is limited to instruments that treat or diagnose fewer than 4,000 people in the United States annually. Second Sight welcomed the news, calling it a game changer. With this approval, we look forward to building a strong surgical network in the United States and recruiting new hospitals that will offer the Argus II retinal implant, said president and CEO Robert Greenberg. In the past 20 years, biotechnology has become the fastest-growing area of scientific research, with new devices going into clinical trials at a breakneck pace. Abionic arm allows amputees to control movements of the prosthesis with their thoughts. A training system called BrainPort is letting people with visual and balance disorders bypass their damaged sensory organs and instead send information to theirbrain through the tongue. Now, a company called Second Sight has received FDA approval to begin U.S. trials of a retinal implant system that gives blind people a limited degree of vision. The second incarnation of Second Sight's retinal prosthesis consists of five main parts: A digital camera that's built into a pair of glasses. It captures images in real time and sends images to a microchip. A video-processing microchip that's built into a handheld unit. It processes images into electricalpulses representing patterns of light and dark and sends the pulses to a radio transmitter in the glasses.

A radio transmitter that wirelessly transmits pulses to a receiver implanted above the ear or under the eye A radio receiver that sends pulses to the retinal implant by a hair-thin implanted wire A retinal implant with an array of 60 electrodes on a chip measuring 1 mm by 1 mm

The entire system runs on abattery pack that's housed with the video processing unit. When thecamera captures an image -- of, say, a tree -- the image is in the form of light and dark pixels. It sends this image to the video processor, which converts the tree-shaped pattern of pixels into a series of electrical pulses that represent "light" and "dark." The processor sends these pulses to a radio transmitter on the glasses, which then transmits the pulses in radio form to a receiver implanted underneath the subject's skin. The receiver is directly connected via a wire to the electrode array implanted at the back of the eye, and it sends the pulses down the wire. When the pulses reach the retinal implant, they excite the electrode array. The array acts as the artificial equivalent of the retina's photoreceptors. The electrodes are stimulated in accordance with the encoded pattern of light and dark that represents the tree, as the retina's photoreceptors would be if they were working (except that the pattern wouldn't be digitally encoded). The electrical signals generated by the stimulated electrodes then travel as neural signals to the visual center of the brain by way of the normal pathways used by healthy eyes -- the optic nerves. In macular degeneration and retinitis pigmentosa, the optical neural pathways aren't damaged. The brain, in turn, interprets these signals as a tree and tells the subject, "You're seeing a tree." It takes some training for subjects to actually see a tree. At first, they see mostly light and dark spots. But after a while, they learn to interpret what the brain is showing them, and they eventually perceive that pattern of light and dark as a tree.

REACTION: An estimated 100,000 people in the United States suffer from retinitis pigmentosa, a disease that slowly kills off the light-sensing cells in the retina, starting with the rod cells responsible for periphery and night vision, and eventually the cone cells, which provide central vision. The result is a gradual tunneling in of the vision, leading eventually to complete blindness. This is a game changer in sight-affecting diseases that represents a huge step forward for the field and for these patients who were without any available treatment options until now. This would further help the clients not to restore their normal vision but rather help them see things its location and movement and even persons. This surgical intervention will prevent accidents and further harm to these clients, and also this will increase their self-esteem by just seeing things in their environment. As the technology rises and improving its functions and uses, maybe for some more years to come this bionic eye will have this colored and clearer vision that will enhance the capabilities of these clients to see their environment. Future software developments will expand the capabilities of the Argus II. The company might develop software that will enable the device to stimulate patients to see color by providing electrical signals at different frequencies. With the help of this system, people who suffer from diseases which cause visual loss will have a means to have their vision regain somehow.

Aklan State University School of Arts and Sciences Banga, Aklan

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Submitted to: Claudette P. Dalida, RN, MAN Clinical Instructor

Submitted by: Elainne Joy Z. Gajulin BSN 4-2

February 16, 2013