The DOI matches its Crossref record; 36 of the 36 references it cites were found in a registry or an index.
Photovoltaic Restoration of Central Vision in Atrophic Age-Related Macular Degeneration
Open accessAbstract
PURPOSE: Loss of photoreceptors in atrophic age-related macular degeneration results in severe visual impairment, although some peripheral vision is retained. To restore central vision without compromising the residual peripheral field, we developed a wireless photovoltaic retinal implant (PRIMA; Pixium Vision, Paris, France) in which pixels convert images projected from video glasses using near-infrared light into electric current to stimulate the nearby inner retinal neurons. DESIGN: We carried out a first-in-human clinical trial to test the safety and efficacy of the prosthesis in patients with geographic atrophy (ClinicalTrials.gov identifier, NCT03333954). PARTICIPANTS: Five patients with geographic atrophy zone of at least 3 optic disc diameters, no foveal light perception, and best-corrected visual acuity of 20/400 to 20/1000 in the worse-seeing study eye. METHODS: The 2-mm wide, 30-μm thick chip, containing 378 pixels (each 100 μm in diameter), was implanted subretinally in the area of atrophy (absolute scotoma). MAIN OUTCOME MEASURES: Anatomic outcomes were assessed with fundus photography and OCT for up to 12 months of follow-up. Prosthetic vision was assessed by mapping light perception, bar orientation, letter recognition, and Landolt C acuity. RESULTS: In all patients, the prosthesis was implanted successfully under the macula, although in 2 patients, it was implanted in unintended locations: within the choroid and off center by 2 mm. All 5 patients could perceive white-yellow prosthetic visual patterns with adjustable brightness in the previous scotomata. The 3 with optimal placement of the implant demonstrated prosthetic acuity of 20/460 to 20/550, and the patient with the off-center implant demonstrated 20/800 acuity. Residual natural acuity did not decrease after implantation in any patient. CONCLUSIONS: Implantation of the PRIMA did not decrease the residual natural acuity, and it restored visual sensitivity in the former scotoma in each of the 5 patients. In 3 patients with the proper placement of the chip, prosthetic visual acuity was only 10% to 30% less than the level expected from the pixel pitch (20/420). Therefore, the use of optical or electronic magnification in the glasses as well as smaller pixels in future implants may improve visual acuity even further.
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“testing showed a good correlation between the number of stimulators and visual acuity, achieving a visual resolution of approximately 1.2 pixels.”
From Visual Prostheses in the Era of Artificial Intelligence Technology (2025) · cites this paper as [35]
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“By this metric, comparison of visual acuity with the device switched ON and OFF showed improvement only for the PRIMA35 and Argus II9 devices.”
From Visual Prostheses in the Era of Artificial Intelligence Technology (2025) · cites this paper as [35]
In the citing paper
“Devices have a size providing a maximum restored visual angle of about 10 • , suitable only for applications where a small part of the visual field is lost, such as AMD [48,49].”
From Advances in visual prostheses: engineering and biological challenges (2022) · cites this paper as [48]
In the citing paper
“The highest visual acuities reported to date, as measured with the Landolt-C test, were 20/460 with the subretinal implant PRIMA (in AMD patients) [48] and 20/546 with the subretinal implant Alpha-AMS (in RP patients) [133].”
From Advances in visual prostheses: engineering and biological challenges (2022) · cites this paper as [48]
In the citing paper
“However, this ideal case is rarely reached and has only been reported for the PRIMA device [48] and some patients with Alpha IMS, most likely with preserved eye movements [154].”
From Advances in visual prostheses: engineering and biological challenges (2022) · cites this paper as [48]
In the citing paper
“So far, flicker fusion has been achieved only for the PRIMA device in AMD patients [48].”
From Advances in visual prostheses: engineering and biological challenges (2022) · cites this paper as [48]
In the citing paper
“Photovoltaic retinal prostheses [48] were the first example of neurostimulation devices providing fully wireless electrical stimulation to the nervous system without the need for implantable batteries or active electronic units.”
From Advances in visual prostheses: engineering and biological challenges (2022) · cites this paper as [48]
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Citations
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Self-citationPhotovoltaic retinal prosthesis with high pixel density
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Motion perception with visual prostheses
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Brain-Computer Interfaces for Vision Recovery in Precortical Vision Loss
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Regenerating Retinal Cells and Restoring Vision
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“71 Follow-up studies on patients with geographic atrophy have demonstrated that the PRIMA system enables the simultaneous perception of central vision and natural peripheral vision while maintaining stable safety profiles.”
Simulation of prosthetic vision with the PRIMA system and enhancement of face representation
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“…have demonstrated the feasibility of restoring partial visual perception, including light perception, object localization, and limited-form vision, the level of restored vision remains substantially below that required for tasks, such as normal reading or detailed object recognition [10–12].”
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What we can learn from nature to restore human vision
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“For example, subretinal systems such as Alpha AMS and PRIMA use 70 × 70 μm electrode units and 100 μm circular electrodes, respectively (Muqit et al. 2024; Palanker et al. 2020).”
Toward Electrical Impedance Tomography of Functional Activity in the RetinaPreprint
Ravagli, E., McEwan, A., Protti, D., & Aristovich, K. Y. (2026) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.64898/2026.10.23.761326
“The worldwide prevalence of RP is about 1 in 4000, for a total of more than 1 million affected individuals [12], while AMD affects more than 8.7% of the population worldwide[13].”
Influential
Metadata
- Authors
- Palanker, D., Le Mer, Y., Mohand-Said, S., Muqit, M., & Sahel, J. A.
- Affiliations
- Stanford University (US)
- Moorfields Eye Hospital NHS Foundation Trust (GB)
- Corresponding author
- Palanker, Daniel
- Venue
- Ophthalmology
- Publisher
- Elsevier BV
- Published
- 2020-08
- Volume
- 127
- Issue
- 8
- Pages
- 1097-1104
- ISSN
- 0161-6420 (ISSN-L)
- PMC
- PMC7384969
- OpenAlex
- W3006860701
- Cited by
- 227
- References
- 36
- Citations by year
- 2026: 31 · 2025: 29 · 2024: 26 · 2023: 37 · 2022: 37 · 2021: 44 · 2020: 22
- FWCI
- 16.03
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Ophthalmology (publishedVersion, cc-by)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- National Institutes of Health
- Topics
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuroscience and Neural Engineering
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Health Sciences › Medicine › Ophthalmology › Retinal Development and Disorders
- Keywords
- dry age-related macular degeneration, geographic atrophy, PRIMA, subretinal implantation, scotoma, photoreceptor loss, implant safety and efficacy, pixel pitch
- MeSH terms
- Electrodes, Implanted, Feasibility Studies, Female, Humans, Macula Lutea, Macular Degeneration, Male, Middle Aged, Visual Perception, Recovery of Function, Tomography, Optical Coherence, Visual Prosthesis
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