Matthew A. Petoe BEng (Hons), PhD , Carla J. Abbott BOptom, PhD , Samuel A. Titchener BEng (Hons), PhD , Maria Kolic BOrth , William G. Kentler BEng , David A.X. Nayagam BEng (Hons), PhD , Elizabeth K. Baglin BOrth , Jessica Kvansakul MSc, PhD , Nick Barnes PhD , Janine G. Walker PhD , Lewis Karapanos BBMed (Hons), MD , Myra B. McGuinness MBiostat, PhD , Lauren N. Ayton BOptom, PhD , Chi D. Luu BOrth (Hons), PhD , Penelope J. Allen MBBS, FRANZCO
{"title":"第二代（44 通道）脉络膜上视网膜假体：单臂可行性临床试验","authors":"Matthew A. Petoe BEng (Hons), PhD , Carla J. Abbott BOptom, PhD , Samuel A. Titchener BEng (Hons), PhD , Maria Kolic BOrth , William G. Kentler BEng , David A.X. Nayagam BEng (Hons), PhD , Elizabeth K. Baglin BOrth , Jessica Kvansakul MSc, PhD , Nick Barnes PhD , Janine G. Walker PhD , Lewis Karapanos BBMed (Hons), MD , Myra B. McGuinness MBiostat, PhD , Lauren N. Ayton BOptom, PhD , Chi D. Luu BOrth (Hons), PhD , Penelope J. Allen MBBS, FRANZCO","doi":"10.1016/j.xops.2024.100525","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><p>To assess the feasibility of a second-generation (44-channel) suprachoroidal retinal prosthesis for provision of functional vision in recipients with end-stage retinitis pigmentosa (RP) over 2.7 years.</p></div><div><h3>Design</h3><p>Prospective, single-arm, unmasked interventional clinical trial.</p></div><div><h3>Participants</h3><p>Four participants, with advanced RP and bare-light perception vision.</p></div><div><h3>Methods</h3><p>The 44-channel suprachoroidal retinal prosthesis was implanted in the worse-seeing eye. Device stability, functionality, and adverse events were investigated at approximately 12-week intervals up to 140 weeks (2.7 years) postdevice activation.</p></div><div><h3>Main Outcome Measures</h3><p>Serious adverse event (SAE) reporting, visual response outcomes, functional vision outcomes, and quality-of-life outcomes.</p></div><div><h3>Results</h3><p>All 4 participants (aged 39–66 years, 3 males) were successfully implanted in 2018, and there were no device-related SAEs over the duration of the study. A mild postoperative subretinal hemorrhage was detected in 2 recipients, which cleared spontaneously within 2 weeks. OCT confirmed device stability and position under the macula. Improvements in localization abilities were demonstrated for all 4 participants in screen-based, tabletop, and orientation and mobility tasks. In addition, 3 of 4 participants recorded improvements in motion discrimination and 2 of 4 participants recorded substantial improvements in spatial discrimination and identification of tabletop objects. Participants reported their unsupervised use of the device included exploring new environments, detecting people, and safely navigating around obstacles. A positive effect of the implant on participants’ daily lives in their local environments was confirmed by an orientation and mobility assessor and participant self-report. Emotional well-being was not impacted by device implantation or usage.</p></div><div><h3>Conclusions</h3><p>The completed clinical study demonstrates that the suprachoroidal prosthesis raises no safety concerns and provides improvements in functional vision, activities of daily living, and observer-rated quality of life.</p></div><div><h3>Financial Disclosure(s)</h3><p>Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.</p></div>","PeriodicalId":74363,"journal":{"name":"Ophthalmology science","volume":"5 1","pages":"Article 100525"},"PeriodicalIF":3.2000,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666914524000617/pdfft?md5=58e184a14bc6df9fdd2eaced905fba58&pid=1-s2.0-S2666914524000617-main.pdf","citationCount":"0","resultStr":"{\"title\":\"A Second-Generation (44-Channel) Suprachoroidal Retinal Prosthesis: A Single-Arm Clinical Trial of Feasibility\",\"authors\":\"Matthew A. 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Device stability, functionality, and adverse events were investigated at approximately 12-week intervals up to 140 weeks (2.7 years) postdevice activation.</p></div><div><h3>Main Outcome Measures</h3><p>Serious adverse event (SAE) reporting, visual response outcomes, functional vision outcomes, and quality-of-life outcomes.</p></div><div><h3>Results</h3><p>All 4 participants (aged 39–66 years, 3 males) were successfully implanted in 2018, and there were no device-related SAEs over the duration of the study. A mild postoperative subretinal hemorrhage was detected in 2 recipients, which cleared spontaneously within 2 weeks. OCT confirmed device stability and position under the macula. Improvements in localization abilities were demonstrated for all 4 participants in screen-based, tabletop, and orientation and mobility tasks. In addition, 3 of 4 participants recorded improvements in motion discrimination and 2 of 4 participants recorded substantial improvements in spatial discrimination and identification of tabletop objects. Participants reported their unsupervised use of the device included exploring new environments, detecting people, and safely navigating around obstacles. A positive effect of the implant on participants’ daily lives in their local environments was confirmed by an orientation and mobility assessor and participant self-report. 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A Second-Generation (44-Channel) Suprachoroidal Retinal Prosthesis: A Single-Arm Clinical Trial of Feasibility
Purpose
To assess the feasibility of a second-generation (44-channel) suprachoroidal retinal prosthesis for provision of functional vision in recipients with end-stage retinitis pigmentosa (RP) over 2.7 years.
Four participants, with advanced RP and bare-light perception vision.
Methods
The 44-channel suprachoroidal retinal prosthesis was implanted in the worse-seeing eye. Device stability, functionality, and adverse events were investigated at approximately 12-week intervals up to 140 weeks (2.7 years) postdevice activation.
All 4 participants (aged 39–66 years, 3 males) were successfully implanted in 2018, and there were no device-related SAEs over the duration of the study. A mild postoperative subretinal hemorrhage was detected in 2 recipients, which cleared spontaneously within 2 weeks. OCT confirmed device stability and position under the macula. Improvements in localization abilities were demonstrated for all 4 participants in screen-based, tabletop, and orientation and mobility tasks. In addition, 3 of 4 participants recorded improvements in motion discrimination and 2 of 4 participants recorded substantial improvements in spatial discrimination and identification of tabletop objects. Participants reported their unsupervised use of the device included exploring new environments, detecting people, and safely navigating around obstacles. A positive effect of the implant on participants’ daily lives in their local environments was confirmed by an orientation and mobility assessor and participant self-report. Emotional well-being was not impacted by device implantation or usage.
Conclusions
The completed clinical study demonstrates that the suprachoroidal prosthesis raises no safety concerns and provides improvements in functional vision, activities of daily living, and observer-rated quality of life.
Financial Disclosure(s)
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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