, 1969, Bach-y-Rita et al., 1998, Collins, 1971, Deroy and Auvray, 2012 and Loomis, 2010). Alternatives to the tactile approach include encoding visual information into audible signals (Capelle et al., 1998, Hanneton et al., 2010, Loomis, 2010 and Meijer, 1992). Such devices have shown great promise, however their uptake has been limited and PD0325901 price development is ongoing (Loomis, 2010 and Reich et al., 2012). Another approach to vision rehabilitation involves the generation of functionally useful visual perception by direct electrical stimulation of the visual pathway (Fig. 1). The application of such stimulation relies on three physiologic principles
(Maynard, 2001): 1. Light can be replaced by electric current to stimulate the perception of vision. Volta (1800) was among the first to describe the visual percepts, or phosphenes
resulting from electrical stimulation of the eye. In the two centuries since this observation, countless experiments on both animals and humans have confirmed that electrical stimulation of the major anatomical landmarks selleck in the human visual pathway produces phosphenes of varying character. Retinal stimulation has been covered extensively in the recent literature, and the reader is directed to reviews by Shepherd et al. (2013), Guenther et al. (2012), Ong and da Cruz (2012), Fernandes et al. (2012), Florfenicol Theogarajan (2012) and Merabet (2011) for additional details.
Briefly, visual prostheses based on electrical stimulation of surviving populations of retinal ganglion cells have progressed substantially in recent years. Retinal stimulation takes advantage of the significant visual information processing that occurs not only in the retina itself (Freeman et al., 2011), but also the lateral geniculate nucleus (Cudeiro and Sillito, 2006 and Wiesel and Hubel, 1966). Electrical stimulation of the retina may be achieved via placement of epiretinal, subretinal, or suprachoroidal stimulating electrode arrays. One such device, the Argus II epiretinal implant developed by Second Sight (Sylmar, California, USA), has recently obtained regulatory approval for marketing in Europe and the United States. The Argus II is based on a 60-electrode array and a spectacles-mounted digital camera. Clinical trials of the device have shown improved reading (da Cruz et al., 2013) and motion detection (Dorn et al., 2013) abilities in many recipients. A variety of other implant designs are in development worldwide. Stingl et al. (2013) recently described the clinical trial results of a subretinal array (Alpha IMS) incorporating 1500 embedded photodiodes and matching stimulating electrodes.