Artificial Visual Information Produced by Retinal Prostheses

Advances in the application of smart materials in the treatment of ophthalmic diseases

Smart materials dynamically sense and respond to physiological signals like reactive oxygen species (ROS), pH, and light, surpassing traditional materials such as poly(lactic-co-glycolic acid), which have high drug loss rates and limited spatiotemporal control. These innovative materials offer new strategies for ophthalmic treatments, with core advantages including targeted delivery via ROS-sensitive nanocarriers, precise regulation through microvalves, and multifunctional integration, such as glucose-responsive contact lenses that create a "sensing-treatment" loop. However, challenges remain, like pathological microenvironment interference with material response specificity, and the need to address long-term biocompatibility and energy dependence issues. This article systematically examines three key treatment barriers: the blood-ocular barrier, immune rejection, and physiological fluctuations, while reviewing innovative smart material design strategies. Future research should focus on biomimetic interface engineering, for example, cornea mimicking nanostructures, AI-driven dynamic optimization like causal network-regulated drug release, and multidisciplinary approaches combining gene editing with smart materials. These efforts aim to shift from structural replacement to physiological function simulation, enabling precise treatment of ophthalmic diseases. Clinical translation must balance innovation with safety, prioritizing clinical value to ensure reliable, widespread application of smart materials in ophthalmology.

Advancements in Ocular Neuro-Prosthetics: Bridging Neuroscience and Information and Communication Technology for Vision Restoration

BACKGROUND

Neuroprosthetics for vision restoration have advanced significantly, incorporating technologies like retinal implants, cortical implants, and non-invasive stimulation methods. These advancements hold the potential to tackle major challenges in visual prosthetics, such as enhancing functionality, improving biocompatibility, and enabling real-time object recognition.

AIM

The aim of this review overview is to provide a comprehensive analysis of the latest advancements in ocular neuroprostheses.

METHODS

A narrative review was conducted, focusing on the latest developments in visual neuroprosthetics. Comprehensive searches were carried out on Google Scholar, PubMed, and Scopus using specific keywords. A specific narrative checklist was applied, alongside a tailored quality assessment methodology, to evaluate the quality of the studies included. A total of sixteen relevant studies from the past three years were included in the review.

RESULTS AND DISCUSSION

The integration of artificial retinas, cortical implants, high technology-enabled prosthetics, gene therapies, nanotechnology, and bioprinting has shown significant promise in enhancing the quality and functionality of vision restoration systems, offering potential to address complex visual impairments and improve independence and mobility for individuals with blindness. These innovations appear to have the potential to transform healthcare systems in the future by enabling more efficient and personalized therapies and prosthetic devices. However, challenges such as energy efficiency, scalability, and the neural dynamics of vision restoration persist, requiring continued interdisciplinary collaboration to refine these technologies, overcome ethical and regulatory hurdles, and ensure their effectiveness in real-world applications.

CONCLUSIONS

While visual neuroprosthetics have made remarkable progress, addressing challenges related to energy consumption and regulatory and ethical concerns will be crucial for ensuring that neuroprosthetic devices can effectively meet the needs of individuals with visual impairments.

Quantitative analyses of how optimally heterogeneous neural codes maximize neural information in jittery transmission environments

Various spike patterns from sensory/motor neurons provide information about the dynamic sensory stimuli. Based on the information theory, neuroscientists have revealed the influence of spike variables on information transmission. Among diverse spike variables, inter-trial heterogeneity, known as jitter, has been observed in physiological neuron activity and responses to artificial stimuli, and it is recognized to contribute to information transmission. However, the relationship between inter-trial heterogeneity and information remains unexplored. Therefore, understanding how jitter impacts the heterogeneity of spiking activities and information encoding is crucial, as it offers insights into stimulus conditions and the efficiency of neural systems. Here, we systematically explored how neural information is altered by number of neurons as well as by each of three fundamental spiking characteristics: mean firing rate (MFR), duration, and cross-correlation (spike time tiling coefficient; STTC). First, we generated groups of spike trains to have specific average values for those characteristics. Second, we quantified the transmitted information rate as a function of each parameter. As population size, MFR, and duration increased, the information rate was enhanced but gradually saturated with further increments in number of cells and MFR. Regarding the cross-correlation level, homogeneous and heterogeneous spike trains (STTCAVG = 0.9 and 0.1) showed the lowest and highest information transmission, respectively. Interestingly however, when jitters were added to mimic physiological noisy environment, the information was reduced by ~ 46% for the spike trains with STTCAVG = 0.1 but rather substantially increased by ~ 63% for the spike trains with STTCAVG = 0.9. Our study suggests that optimizing various spiking characteristics may enhance the robustness and amount of neural information transmitted.

Shedding Light on Cardiac Excitation: In Vitro and In Silico Analysis of Native Ca2+ Channel Activation in Guinea Pig Cardiomyocytes Using Organic Photovoltaic Devices

OBJECTIVE

This study aims to explore the potential of organic electrolytic photocapacitors (OEPCs), an innovative photovoltaic device, in mediating the activation of native voltage-gated Cav1.2 channels (ICa,L) in Guinea pig ventricular cardiomyocytes.

METHODS

Whole-cell patch-clamp recordings were employed to examine light-triggered OEPC mediated ICa,L activation, integrating the channel's kinetic properties into a multicompartment cell model to take intracellular ion concentrations into account. A multidomain model was additionally incorporated to evaluate effects of OEPC-mediated stimulation. The final model combines external stimulation, multicompartmental cell simulation, and a patch-clamp amplifier equivalent circuit to assess the impact on achievable intracellular voltage changes.

RESULTS

Light pulses activated ICa,L, with amplitudes similar to voltage-clamp activation and high sensitivity to the L-type Ca2+ channel blocker, nifedipine. Light-triggered ICa,L inactivation exhibited kinetic parameters comparable to voltage-induced inactivation.

CONCLUSION

OEPC-mediated activation of ICa,L demonstrates their potential for nongenetic optical modulation of cellular physiology potentially paving the way for the development of innovative therapies in cardiovascular health. The integrated model proves the light-mediated activation of ICa,L and advances the understanding of the interplay between the patch-clamp amplifier and external stimulation devices.

SIGNIFICANCE

Treating cardiac conduction disorders by minimal-invasive means without genetic modifications could advance therapeutic approaches increasing patients' quality of life compared with conventional methods employing electronic devices.

Low-Power Perovskite Neuromorphic Synapse with Enhanced Photon Efficiency for Directional Motion Perception

The advancement of artificial intelligent vision systems heavily relies on the development of fast and accurate optical imaging detection, identification, and tracking. Framed by restricted response speeds and low computational efficiency, traditional optoelectronic information devices are facing challenges in real-time optical imaging tasks and their ability to efficiently process complex visual data. To address the limitations of current optoelectronic information devices, this study introduces a novel photomemristor utilizing halide perovskite thin films. The fabrication process involves adjusting the iodide proportion to enhance the quality of the halide perovskite films and minimize the dark current. The photomemristor exhibits a high external quantum efficiency of over 85%, which leads to a low energy consumption of 0.6 nJ. The spike timing-dependent plasticity characteristics of the device are leveraged to construct a spiking neural network and achieve a 99.1% accuracy rate of directional perception for moving objects. The notable results offer a promising hardware solution for efficient optoneuromorphic and edge computing applications.

Effects on Retinal Stimulation of the Geometry and the Insertion Location of Penetrating Electrodes

Retinal implants have been developed and implanted to restore vision from outer retinal degeneration, but their performance is still limited due to the poor spatial resolution. To improve the localization of stimulation, microelectrodes in various three-dimensional (3D) shapes have been investigated. In particular, computational simulation is crucial for optimizing the performance of a novel microelectrode design before actual fabrication. However, most previous studies have assumed a uniform conductivity for the entire retina without testing the effect of electrodes placement in different layers. In this study, we used the finite element method to simulate electric fields created by 3D microelectrodes of three different designs in a retina model with a stratified conductivity profile. The three electrode designs included two conventional shapes - a conical electrode (CE) and a pillar electrode (PE); we also proposed a novel structure of pillar electrode with an insulating wall (PEIW). A quantitative comparison of these designs shows the PEIW generates a stronger and more confined electric field with the same current injection, which is preferred for high-resolution retinal prostheses. Moreover, our results demonstrate both the magnitude and the shape of potential distribution generated by a penetrating electrode depend not only on the geometry, but also substantially on the insertion depth of the electrode. Although epiretinal insertions are mainly discussed, we also compared results for subretinal insertions. The results provide valuable insights for improving the spatial resolution of retinal implants using 3D penetrating microelectrodes and highlight the importance of considering the heterogeneity of conductivities in the retina.

Electrically-evoked responses for retinal prostheses are differentially altered depending on ganglion cell types in outer retinal neurodegeneration caused by Crb1 gene mutation

Background

Microelectronic prostheses for artificial vision stimulate neurons surviving outer retinal neurodegeneration such as retinitis pigmentosa (RP). Yet, the quality of prosthetic vision substantially varies across subjects, maybe due to different levels of retinal degeneration and/or distinct genotypes. Although the RP genotypes are remarkably diverse, prosthetic studies have primarily used retinal degeneration (rd) 1 and 10 mice, which both have Pde6b gene mutation. Here, we report the electric responses arising in retinal ganglion cells (RGCs) of the rd8 mouse model which has Crb1 mutation.

Methods

We first investigated age-dependent histological changes of wild-type (wt), rd8, and rd10 mice retinas by H&E staining. Then, we used cell-attached patch clamping to record spiking responses of ON, OFF and direction selective (DS) types of RGCs to a 4-ms-long electric pulse. The electric responses of rd8 RGCs were analyzed in comparison with those of wt RGCs in terms of individual RGC spiking patterns, populational characteristics, and spiking consistency across trials.

Results

In the histological examination, the rd8 mice showed partial retinal foldings, but the outer nuclear layer thicknesses remained comparable to those of the wt mice, indicating the early-stage of RP. Although spiking patterns of each RGC type seemed similar to those of the wt retinas, correlation levels between electric vs. light response features were different across the two mouse models. For example, in comparisons between light vs. electric response magnitudes, ON/OFF RGCs of the rd8 mice showed the same/opposite correlation polarity with those of wt mice, respectively. Also, the electric response spike counts of DS RGCs in the rd8 retinas showed a positive correlation with their direction selectivity indices (r = 0.40), while those of the wt retinas were negatively correlated (r = -0.90). Lastly, the spiking timing consistencies of late responses were largely decreased in both ON and OFF RGCs in the rd8 than the wt retinas, whereas no significant difference was found across DS RGCs of the two models.

Conclusion

Our results indicate the electric response features are altered depending on RGC types even from the early-stage RP caused by Crb1 mutation. Given the various degeneration patterns depending on mutation genes, our study suggests the importance of both genotype- and RGC type-dependent analyses for retinal prosthetic research.

Potential therapeutic strategies for photoreceptor degeneration: the path to restore vision

Photoreceptors (PRs), as the most abundant and light-sensing cells of the neuroretina, are responsible for converting light into electrical signals that can be interpreted by the brain. PR degeneration, including morphological and functional impairment of these cells, causes significant diminution of the retina's ability to detect light, with consequent loss of vision. Recent findings in ocular regenerative medicine have opened promising avenues to apply neuroprotective therapy, gene therapy, cell replacement therapy, and visual prostheses to the challenge of restoring vision. However, successful visual restoration in the clinical setting requires application of these therapeutic approaches at the appropriate stage of the retinal degeneration. In this review, firstly, we discuss the mechanisms of PR degeneration by focusing on the molecular mechanisms underlying cell death. Subsequently, innovations, recent developments, and promising treatments based on the stage of disorder progression are further explored. Then, the challenges to be addressed before implementation of these therapies in clinical practice are considered. Finally, potential solutions to overcome the current limitations of this growing research area are suggested. Overall, the majority of current treatment modalities are still at an early stage of development and require extensive additional studies, both pre-clinical and clinical, before full restoration of visual function in PR degeneration diseases can be realized.

Short pulses of epiretinal prostheses evoke network-mediated responses in retinal ganglion cells by stimulating presynaptic neurons

OBJECTIVE

Microelectronic retinal implant aims to restore functional vision with electric stimulation. Short pulses are generally known to directly activate retinal ganglion cells (RGCs) with a notion of one or two spike(s) per pulse. In the present work, we systematically explore network-mediated responses that arise from various short pulses in both normal and degenerate retinas.

APPROACH

Cell-attached patch clamping was used to record spiking responses of RGCs in wild-type (C57BL/6J) and retinal degeneration (rd10) mice. Alpha RGCs of the mouse retinas were targeted by their large soma sizes and classified by their responses to spot flashes. Then, RGCs were electrically stimulated by various conditions such as duration (100-460 μs), count (1-10), amplitude (100-400 μA), and repeating frequency (10-40 Hz) of short pulses. Also, their responses were compared with each own response to a single 4-ms-long pulse which is known to evoke strong indirect responses.

MAIN RESULTS

Short pulses evoked strong network-mediated responses not only in both ON and OFF types of RGCs in the healthy retinas but also in RGCs of the severely degenerate retina. However, the spike timing consistency across repeats not decreased significantly in the rd10 RGCs compared to the healthy ON and OFF RGCs. Network-mediated responses of ON RGCs were highly dependent on the current amplitude of stimuli but much less on the pulse count and the repetition frequency. In contrast, responses of OFF RGCs were more influenced by the number of stimuli than the current amplitude.

SIGNIFICANCE

Our results demonstrate that short pulses also elicit indirect responses by activating presynaptic neurons. In the case of the commercial retinal prostheses using repeating short pulses, there is a possibility that the performance of clinical devices is highly related to the preserved retinal circuits. Therefore, examination of surviving retinal neurons in patients would be necessary to improve the efficacy of retinal prostheses.

Structure-Function Relationship in Patients with Retinitis Pigmentosa and Hyperautofluorescent Rings

This study aimed to investigate the association between retinal sensitivity and retinal microstructures in fundus autofluorescence (FAF) and optical coherence tomography (OCT) in patients with retinitis pigmentosa (RP) and hyperautofluorescent (hyperAF) rings. This cross-sectional study included 44 eyes from 26 consecutive patients with RP. The morphological geometry of the hyperAF ring, such as three distinct FAF regions, hyperAF ring area, and longest diameter of the hyperAF ring on FAF, and the retinal microstructure, such as total retinal thickness (TRT) and outer retinal thickness (ORT), on OCT, were evaluated. A strong correlation of mean retinal sensitivity with hyperAF ring area (R = 0.8013, p < 0.001) and longest diameter of the hyperAF ring (R = 0.9072, p < 0.001) was observed. Segmented linear regression (SLR) analysis revealed breakpoints of 12.83 mm² and 5.21 mm, respectively. ORT (R = 0.6551, p < 0.001) was more strongly correlated with retinal sensitivity than TRT (R = 0.2732, p < 0.001). SLR analysis revealed a breakpoint between the ORT and retinal sensitivity of 145.12 μm. In patients with RP and hyperAF rings, retinal sensitivity was strongly associated with the morphological geometry of the hyperAF ring. ORT, rather than TRT, strongly correlated with retinal sensitivity.

Ultrasound stimulation for non-invasive visual prostheses

Globally, it is estimated there are more than 2.2 billion visually impaired people. Visual diseases such as retinitis pigmentosa, age-related macular degeneration, glaucoma, and optic neuritis can cause irreversible profound vision loss. Many groups have investigated different approaches such as microelectronic prostheses, optogenetics, stem cell therapy, and gene therapy to restore vision. However, these methods have some limitations such as invasive implantation surgery and unknown long-term risk of genetic manipulation. In addition to the safety of ultrasound as a medical imaging modality, ultrasound stimulation can be a viable non-invasive alternative approach for the sight restoration because of its ability to non-invasively control neuronal activities. Indeed, recent studies have demonstrated ultrasound stimulation can successfully modulate retinal/brain neuronal activities without causing any damage to the nerve cells. Superior penetration depth and high spatial resolution of focused ultrasound can open a new avenue in neuromodulation researches. This review summarizes the latest research results about neural responses to ultrasound stimulation. Also, this work provides an overview of technical viewpoints in the future design of a miniaturized ultrasound transducer for a non-invasive acoustic visual prosthesis for non-surgical and painless restoration of vision.