用于外层视网膜病变的表层型人工视网膜技术(英文)

Epiretinal prosthesis for outer retinal degenerative diseases

老年黄斑变性和色素性视网膜炎是两种主要外层视网膜变性疾病,也是致盲的主要眼病。对于这种光感受器受损的视网膜疾病,人工视网膜技术是一种非常有希望的治疗途径。现在的人工视网膜技术都是基于神经电刺激发展起来的。在过去的二十多年时间里,人工视网膜技术主要分为两大方向:外层型和表层型。两种人工视网膜技术各有优缺点。对于表层型人工视网膜,植入更为方便,并且可以利用玻璃腔的空间对植入物进行散热。本文首先从视网膜多层结构的信号转换和传递功能出发,简单的介绍了人工视网膜技术的概念;概括了表层型视网膜电刺激需要考虑的一些重要方面;最后总结了美国、德国和日本的研究者研究的几种表层型人工视网膜方案。可以肯定,随着各相关学科的发展,人工视网膜将在不久的将来得到广泛的应用。

Age-related macular degeneration （AMD） and retinitis pigmentosa （RP） are common outer retinal degenerative problems, which are also the predominant causes of most blinding retinal diseases. Retinal prosthesis is a promising solution for such photoreceptor degeneration diseases. Most of current concepts for a retinal prosthesis are based on neuronal electrical stimulation. In the past twenty years, retinal prosthesis has been developed in two different directions： epiretinal prosthesis and subretinal prosthesis. Each prosthesis technique has its advantages and disadvantages. For epiretinal prosthesis, it is easier to be implanted and has the advantage of keeping most of the electronics in the vitreous cavity, off the retinal surface, which greatly helps in dissipating the heat generated by the implant device. In this paper, a brief overview of retinal prostheses concepts is introduced. After that, several important aspects of epiretinal electrical stimulation will be discussed. Moreover, some practical epiretinal prosthesis devices developed by researchers in United States, Germany and Japan in the past have been reviewed. We hope that the devices will be used widely in the near future.