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Age-related macular degeneration (AMD) is one of the leading causes of
blindness in the developed world, with an incidence of 1:500 in patients
aged 55–64, and 1:8 in patients over 85 . Retinitis pigmentosa
(RP) is an inherited disease blinding about 1 in every 4000 individuals much
earlier in life . In both of these conditions the photoreceptor layer
degenerates, while the inner retinal neurons survive to a large extent
[3–5]. Electrically activating these neurons provides an alternative
route for visual information and raises hope for the restoration of sight to
In a normal retina, photoreceptors convert light into neural signals that are
processed by inner retinal neurons, leading to generation of action
potentials in the retinal ganglion cells (RGCs). These signals travel to the
brain through the optic nerve and serve as the basis for visual perception.
Electrical stimulation of the retina with microelectrodes can also produce
action potentials in RGCs, creating spatially patterned percepts of light
called phosphenes. Indeed, recent clinical trials with retinal prosthetic
electrode arrays have restored visual acuity to subjects blinded by retinal
degeneration up to 20/1200 using epiretinal placement (facing the
ganglion cell side) , and up to 20/550 with subretinal
implantation . While this serves as an important proof of concept with
clinically useful implications, existing retinal prosthesis designs have a
number of shortcomings.
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