Rehabilitation of lost functional vision with the Argus II retinal prosthesis

• Published in: Canadian journal of ophthalmology 2018-02, Vol.53 (1), p.14-22
• Main Authors: Markowitz, Michelle, Rankin, Mark, Mongy, Mohamed, Patino, Beatrice E., Manusow, Joshua, Devenyi, Robert G., Markowitz, Samuel N.
• Format: Article
• Language: English
• Subjects: Canada; Humans; Prosthesis Design; Prosthesis Implantation - methods; Retina - physiopathology; Retina - surgery; Retinitis Pigmentosa - complications; Retinitis Pigmentosa - physiopathology; Retinitis Pigmentosa - surgery; Vision, Low - physiopathology; Vision, Low - rehabilitation; Visual Acuity; Visual Prosthesis
• ISSN: 0008-4182; 1715-3360
• DOI: 10.1016/j.jcjo.2017.12.001

The Argus II retinal prosthesis is the first commercially available device for restoration of vision in patients with Retinitis Pigmentosa or with similar retinal pathology who still have minimal residual native vision. The technology is able to restore vision with production of artificial visual percepts which usually are given adequate useful interpretation by the visual system in most implanted patients. The technology usually produces visual perception at the level of shape identification or better in some cases enabling in many less dependence on vision substitution devices and skills. There is no consensus among vision rehabilitation practitioners on single methods for assessments, outcome measures and training, yet there is constant progress in these areas of concern. Hence the current vision rehabilitation practice related to the implantation of the Argus II retinal prosthesis is a work in progress with many learning opportunities for all involved. All agree that implementation of this technology in clinical practice requires the combined work of a multi-disciplinary team which includes a specialized surgical team as well as a specialized rehabilitation team in order to obtain optimal results. Our own experience is presented in this paper and indicates so far that the Argus II technology is beneficial to patients and that it could be successfully managed within the Canadian heath care system. La prothèse rétinienne Argus II est le premier dispositif commercial qui permette de restaurer la vision chez les patients atteints de rétinite pigmentaire ou d’autres affections rétiniennes et qui disposent d’un minimum de vision résiduelle. La technologie autorise le rétablissement de la vision et la production de préceptes visuels artificiels, qui génèrent habituellement une interprétation utile adéquate par le système visuel chez la plupart des patients. La technologie donne généralement lieu à une perception visuelle de type identification des formes, ou mieux dans certains cas, ce qui réduit la dépendance du patient envers les dispositifs et les habiletés de substitution visuelle. S’il n’existe aucun consensus au sein des praticiens de la réadaptation en déficience visuelle quant à une méthode unique en matière d’évaluations, de paramètres de mesure et de formation, il n’en demeure pas moins que l’on observe des progrès constants à ces égards. Ainsi, les techniques actuelles de réadaptation en déficience visuelle à la suite de l’implantation de la prothè