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  • OCT Assessment of Retinal Changes With Retinal Prosthesis

    By Lynda Seminara
    Selected and Reviewed By: Neil M. Bressler, MD, and Deputy Editors
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    Journal Highlights

    JAMA Ophthalmology, March 2019

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    Little is known about postoperative ret­inal changes at the juncture of an im­plant electrode array and the retina—or whether the potential alterations could affect visual performance. To address these gaps, Rizzo et al. looked at morphologic changes in recipients of a retinal prosthesis and found that 50% had fibrosis-like hyperreflective tissue at the interface between the array and retina. Although this often led to retinal schisis, visual performance was not impaired.

    The study was a noncomparative consecutive case series that involved review of pre- and postoperative find­ings of optical coherence tomography (OCT) for 33 eyes (33 patients) that received the Argus II Retinal Prosthesis System. This is the first—and, current­ly, the only—epiretinal device with commercial approval in Europe and North America for use in patients with blindness due to retinitis pigmentosa.

    All procedures were performed by the same surgeon, at one of two centers in Italy. Participants received compre­hensive exams before surgery, on post­operative day 1, and at months 1, 3, 6, 12, and 24. Yearly follow-up continued thereafter. Only the patients who com­pleted at least six months of follow-up were included in the analysis.

    Of the 20 patients eligible for analysis, all were white, and 12 (60%) were male. The mean age was 57.4 years. OCT findings showed fibrosis-like hyperreflective tissue, limited to the interface between the array and the ret­ina, in 10 eyes (50%). In nine of these eyes, the fibrosis progressed to retinal schisis. Despite this, there was no dete­rioration of visual performance, which was assessed prospectively with visual function tests (square localization and direction of motion).

    These results show that OCT can be used to detect retinal anatomic changes after implantation of the Argus II. The authors acknowledged that more re­search is needed to thoroughly inves­tigate the morphologic features and pathogenesis of these changes. (Also see related commentary by Julia A. Haller, MD, in the same issue.)

    The original article can be found here.