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Title: Factors Affecting Perceptual Thresholds in a Suprachoroidal Retinal Prosthesis
Authors: Shivdasani, Mohit
Sinclair, Nicholas
Dimitrov, Peter
Varsamidis, Mary
Ayton, Lauren
Luu, Chi
Perera, Thushara
McDermott, Hugh
Blamey, Peter
Keywords: retinal prosthesis
retinitis pigmentosa
Issue Date: Oct-2014
Publisher: The Association for Research in Vision and Ophthalmology Inc
Citation: Shivdasani, M. N., Sinclair, N. C., Dimitrov, P. N., Varsamidis, M., Ayton, L. N., Luu, C. D., et al. (2014). Factors affecting perceptual thresholds in a suprachoroidal retinal prosthesis. Investigative Ophthalmology & Visual Science, 55(10), 6467-6481
Abstract: PURPOSE: The suprachoroidal location for a retinal prosthesis provides advantages over other locations in terms of a simplified surgical procedure and a potentially more stable electrode-neural interface. The aim of this study was to assess the factors affecting perceptual thresholds, and to optimize stimulus parameters to achieve the lowest thresholds in patients implanted with a suprachoroidal retinal prosthesis. METHODS: Three patients with profound vision loss from retinitis pigmentosa were implanted with a suprachoroidal array. Perceptual thresholds measured on individual electrodes were analyzed as a function of stimulus (return configuration, pulse polarity, pulse width, interphase gap, and rate), electrode (area and number of ganged electrodes), and clinical (retinal thickness and electrode-retina distance) parameters. RESULTS: A total of 92.8% of 904 measurements made up to 680 days post implantation yielded thresholds (range, 44-436 nanocoulombs [nC]) below the safe charge limit. Thresholds were found to vary between individuals and to depend significantly on electrode-retina distance, negligibly on retinal thickness, and not on electrode area or the number of ganged electrodes. Lowest thresholds were achieved when using a monopolar return, anodic-first polarity, short pulse widths (100 μs) combined with long interphase gaps (500 μs), and high stimulation rates (≥400 pulses per second [pps]). CONCLUSIONS: With suprachoroidal stimulation, anodic-first pulses with a monopolar return are most efficacious. To enable high rates, an appropriate combination of pulse width and interphase gap must be chosen to ensure low thresholds and electrode voltages. Electrode-retina distance needs to be monitored carefully owing to its influence on thresholds. These results inform implantable stimulator specifications for a suprachoroidal retinal prosthesis. (ClinicalTrials.gov number, NCT01603576.).
URI: http://repository.bionicsinstitute.org:8080/handle/123456789/116
Appears in Collections:Bionic Vision Research Publications

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