Simultaneous perception of prosthetic and natural vision in AMD patients
Open accessPublished version of a preprint
Abstract
Loss of photoreceptors in atrophic age-related macular degeneration (AMD) results in severe visual impairment. Since the low-resolution peripheral vision is retained in such conditions, restoration of central vision should not jeopardize the surrounding healthy retina and allow for simultaneous use of the natural and prosthetic sight. This interim report, prespecified in the study protocol, presents the first clinical results with a photovoltaic substitute of the photoreceptors providing simultaneous use of the central prosthetic and peripheral natural vision in atrophic AMD. In this open-label single group feasibility trial (NCT03333954, recruitment completed), five patients with geographic atrophy have been implanted with a wireless 2 x 2 mm-wide 30 µm-thick device, having 378 pixels of 100 µm in size. All 5 patients achieved the primary outcome of the study by demonstrating the prosthetic visual perception in the former scotoma. The four patients with a subretinal placement of the chip demonstrated the secondary outcome: Landolt acuity of 1.17 ± 0.13 pixels, corresponding to the Snellen range of 20/460–20/565. With electronic magnification of up to a factor of 8, patients demonstrated prosthetic acuity in the range of 20/63–20/98. Under room lighting conditions, patients could simultaneously use prosthetic central vision and their remaining peripheral vision in the implanted eye and in the fellow eye.
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The Argus II and PRIMA devices were designed to reduce FOV even further, thereby providing improved image resolution through a digital zoom.
“The Argus II and PRIMA devices were designed to reduce FOV even further, thereby providing improved image resolution through a digital zoom.9,10,65”
From Visual Prostheses in the Era of Artificial Intelligence Technology (2025) · cites this paper as [10]
The Results report that PRIMA-2 offers electronic magnification, and the Discussion reports improved acuity with magnification. But the paper does not say Argus II and PRIMA were designed to reduce field of view for that purpose; the Results give PRIMA-2 a slightly wider projected field than PRIMA-1 (18.5° versus 17.5°). Argus II appears only in a reference, not in this design comparison. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe number of phosphenes that can be accurately elicited is limited to just a few hundred.
“Notably, the number of phosphenes that can be accurately elicited is limited to just a few hundred.10”
From Visual Prostheses in the Era of Artificial Intelligence Technology (2025) · cites this paper as [10]
The Introduction (page not specified) says the PRIMA implant contains 378 pixels, and the Results report prosthetic visual acuity close to pixel size in several patients. This supports a few-hundred-pixel scale for this device, but the paper does not establish that accurately elicited phosphenes are generally limited to a few hundred or that each pixel elicits a distinct phosphene. (LLM, conf=0.84)
Experimental — accuracy not yet measuredSubretinal 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.
“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 [49]
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References 23 · Cited by 140
- Authors
- Palanker, D., Le Mer, Y., Mohand-Said, S., & Sahel, J. A.
- Affiliations
- Stanford University (US)
- Centre National de la Recherche Scientifique (FR)
- Corresponding author
- Palanker, D.
- Venue
- Nature Communications
- Published
- 2022-01-26
- Volume
- 13
- Issue
- 1
- Pages
- 513-513
- ISSN
- 2041-1723 (ISSN-L)
- PMC
- PMC8792035
- OpenAlex
- W4226061778
- Cited by
- 140
- References
- 23
- Citations by year
- 2026: 35 · 2025: 22 · 2024: 26 · 2023: 36 · 2022: 19 · 2021: 1 · 2020: 1
- FWCI
- 11.37
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Nature Communications (publishedVersion, cc-by)
- Research Square (acceptedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- HAL (submittedVersion, other-oa)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Research to Prevent Blindness (EY08098)
- Bpifrance
- Agence Nationale de la Recherche (P30 EY08098, ANR‐10‐LABX‐65, ANR18, 10-LABX-65, ANR-18-IAHU-0001, ANR-10, ANR-10-LABX, ANR-18-IAHU-01)
- Institut National de la Santé et de la Recherche Médicale
- Direction Générale de l’offre de Soins
- National Institutes of Health (EY08098)
- Direction de l’hospitalisation et de l’offre de Soins
- National Eye Institute (R01EY027786, P30EY008098, P30EY026877)
- Topics
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuroscience and Neural Engineering
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Retinal Development and Disorders
- Keywords
- dry age-related macular degeneration, geographic atrophy, photoreceptor replacement, subretinal implant, peripheral vision, scotoma, visual acuity
- MeSH terms
- Aged, Aged, 80 and over, Electric Stimulation, Electric Stimulation Therapy, Equipment Design, Eyeglasses, Humans, Macular Degeneration, Retina, Vision Disorders, Visual Acuity, Visual Perception, Treatment Outcome, Geographic Atrophy, Visual Prosthesis
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