Model-Based Recommendations for Optimal Surgical Placement of Epiretinal Implants.
Model-Based Recommendations for Optimal Surgical Placement of Epiretinal Implants.
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基于模型的视网膜前植入物最佳手术放置建议。
DOI：
10.1007/978-3-030-32254-0_44
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Rokem,Ariel
中科院分区：
文献类型：
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作者：
Beyeler,Michael;Boynton,GeoffreyM;Fine,Ione;Rokem,Ariel
目前的电子视网膜植入物的主要限制是，除了刺激预期的视网膜神经节细胞之外，它们还刺激通过的轴突纤维，产生限制所产生的视觉体验的质量的感知“条纹”。最近的证据表明，之间的依赖关系的形状引起的视觉感受和视网膜的刺激电极的位置。然而，这方面的知识还没有被纳入视网膜植入手术的位置。在这里，我们系统地探讨了可能的植入物配置的空间，为电极阵列的最佳眼内定位提出建议。使用一个精神病理学验证的计算模型，我们证明了更好的种植体放置有可能减少现有种植体使用者轴突激活的空间范围高达55%。重要的是，从模拟的虚拟患者群体中推断出的最佳植入位置在手术上是可行的，并且在个体之间相对稳定。这项研究是在视网膜植入手术的患者特定计划中使用计算机模拟的第一步。
A major limitation of current electronic retinal implants is that in addition to stimulating the intended retinal ganglion cells, they also stimulate passing axon fibers, producing perceptual ‘streaks’ that limit the quality of the generated visual experience. Recent evidence suggests a dependence between the shape of the elicited visual percept and the retinal location of the stimulating electrode. However, this knowledge has yet to be incorporated into the surgical placement of retinal implants. Here we systematically explored the space of possible implant configurations to make recommendations for optimal intraocular positioning of the electrode array. Using a psychophysically validated computational model, we demonstrate that better implant placement has the potential to reduce the spatial extent of axonal activation in existing implant users by up to55%. Importantly, the best implant location, as inferred from a population of simulated virtual patients, is both surgically feasible and is relatively stable across individuals. This study is a first step towards the use of computer simulations in patient-specific planning of retinal implant surgery.