Inovaie n medicin: primul ochi bionic, implantat unui pacient

care i pierduse vederea central

Chirurgii din oraul britanic Manchester au realizat primul implant din lume al unui ochi
bionic pe un pacient diagnosticat cu degenerescen macular legat de vrst (DMLV), o afeciune
care reprezint principala cauz de orbire n rile dezvoltate, informeaz bbc.com.
Ray Flynn, n vrst de 80 de ani, suferea de degenerescen macular legat de vrst
(DMLV), o afeciune ce provoac pierderea total a vederii centrale.Pacientul folosete n prezent
un implant retinian care transform n imagini nregistrrile video realizate de o camer video
miniatural ataat de ochelarii si. Folosind noul implant retinian i tehnologia asociat acestuia,
pacientul poate s urmreasc fr probleme direcia de deplasare a unor linii albe pe ecranul unui
computer. De asemenea, el poate s vad fr probleme siluetele umane i formele obiectelor.
Ray Flyn s-a declarat ncntat de acest implant i sper c, n timp, acesta i va ameliora
vederea suficient de mult pentru a-l ajuta n activitile sale zilnice, precum grdinritul i mersul la
cumprturi.
Implantul Argus II, conceput de firma american Second Sight, a fost anterior folosit pentru
a reda un fel de vedere parial pacienilor care au orbit din cauza unei afeciuni rare, denumit
retinit pigmentar. Noua operaie, realizat la Royal Eye Hospital din Manchester, a reprezentat
prima utilizare a dispozitivului pe un pacient cu DMLV, o maladie care afecteaz cel puin o
jumtate de milion de persoane n Marea Britanie. nainte de operaie, Ray Flynn i pierduse
complet vederea central, dar i pstrase o parte din vederea periferic. Operaia a durat patru ore i
a fost coordonat de medicul argentinian Paulo Stanga, profesor de oftalmologie i regenerare
retinian la Universitatea din Manchester i chirurg vitreo-retinian la Royal Eye Hospital din
Manchester. "Progresul fcut de domnul Flynn este cu adevrat remarcabil, el a nceput s vad deja
siluetele oamenilor i formele obiectelor ntr-un mod foarte eficient. Cred c acesta ar putea fi
nceputul pentru o nou er pentru pacienii care i-au pierdut vederea", a declarat Paulo Stanga.
Ochiul bionic primete informaiile vizuale de la o camer video miniatural amplasat pe ochelarii
purtai de pacient. Imaginile sunt convertite n impulsuri electrice i transmise wireless la o reea de
electrozi miniaturali ataai de retin. Electrozii stimuleaz celulele rmase funcionale de la nivelul
retinei, care trimit mai departe acele informaii vizuale ctre creier. Exist dou forme de
degenerescen macular legat de vrst - uscat i umed. Forma uscat afecteaz 85% din totalul
pacienilor cu DMLV, cauzeaz pierderea treptat a vederii centrale, dar nu afecteaz vederea
periferic. Potrivit Macular Society, peste 44.000 de persoane din Marea Britanie dezvolt n fiecare
an forma uscat a DMLV. Ali patru pacieni cu acest tip de DMLV vor beneficia de acest implant
revoluionar la acelai spital din Manchester, n cadrul unui test clinic. Implantul Argus II cost
aproximativ 150.000 de lire sterline, ns aceast sum include cheltuielile de spitalizare i preul
operaiei. n schimb, toi pacienii din testul clinic vor fi tratai gratuit.
The Implant
The implant is an epiretinal prosthesis surgically implanted in and on the eye that includes an
antenna, an electronics case, and an electrode array.

The External Equipment

The external equipment includes glasses, a video processing unit (VPU) and a cable.

How Is Argus II Designed To Produce Sight?

In a healthy eye, the photoreceptors (rods and cones) in the retina convert light into tiny
electrochemical impulses that are sent through the optic nerve and into the brain, where they are
decoded into images. If the photoreceptors no longer function correctlydue to conditions such as
retinitis pigmentosathe first step in this process is disrupted, and the visual system cannot
transform light into images.
The Argus II Retinal Prosthesis System ("Argus II") is designed to bypass the damaged
photoreceptors altogether. A miniature video camera housed in the patient's glasses captures a scene.
The video is sent to a small patient-worn computer (i.e., the video processing unit VPU) where it
is processed and transformed into instructions that are sent back to the glasses via a cable. These
instructions are transmitted wirelessly to an antenna in the implant. The signals are then sent to the
electrode array, which emits small pulses of electricity. These pulses are intended to bypass the
damaged photoreceptors and stimulate the retinas remaining cells, which transmit the visual
information along the optic nerve to the brain. This process is intended to create the perception of
patterns of light which patients can learn to interpret as visual patterns.
Disclaimer: this animation is intended to demonstrate how the system operates, and may not reflect
the specific visual performance of a given user of the system.

Key Features of Argus II

The Argus II Retinal Prosthesis System ("Argus II") is the world's first and only approved device
intended to restore some functional vision for people suffering from blindness due to severe to
profound retinitis pigmentosa. Moreover, it offers the following benefits:
Most clinical experience of any retinal prosthesis ever developed
Improvements in ability to perform visual tasks demonstrated in many patients
Upgradable external hardware and software to benefit from future innovations
Minimal time from implantation to first system use and use at home
Implant is MR conditional (VPU and glasses are MR unsafe and should not be worn inside
an MR system room)
Video processor with adjustable settings for individual preferences, for example:
Edge enhancement
Contrast enhancement
20 maximum possible field of view
Can be compared to a 30 cm ruler held out at arm's length
Audible signals that provide information on system functionality

What is it? The Argus II Retinal Prosthesis System is the first implanted device to treat adults with
severe retinitis pigmentosa. The System has three parts: a small electronic device implanted in and
around the eye, a tiny video camera attached to a pair of glasses, and a video processing unit that is
worn or carried by the patient.
How does it work? The patient wears glasses with an attached video camera that captures images
of the surrounding area. These images become an electrical signal which is processed by the video
processing unit. The signal is then wirelessly delivered to the eye stimulating the retina. This
electrical stimulation of the retina is recognized by the brain as spots of light.
When is it used? The Argus II Retinal Prosthesis System is intended for patients aged 25 years and

older with bare or no light perception vision caused by advanced retinitis pigmentosa.
What will it accomplish? The Argus II Retinal Prosthesis System is designed to improve the visual
function of patients and may produce the sensation of light. Results of the clinical study showed
that the System helped subjects: identify the location or movement of objects and people; recognize
large letters, words, or sentences; and helped in other activities of daily life, such as detecting street
curbs and walking on a sidewalk without stepping off.