- •Visual Prosthetics
- •Preface
- •Acknowledgments
- •Contents
- •Contributors
- •1.1 The Visual System as an Engineering Compromise
- •1.2 An Overview of Human Visual System Architecture
- •1.2.1 Architecture and Basic Function of the Eye
- •1.2.2 Layout of the Retino-Cortical Pathway
- •1.2.3 Layout of the Subcortical Pathways
- •1.3 An Overview of Human Visual Function
- •1.3.1 Roles of Central (Foveal) Vision
- •1.3.2 Roles of Peripheral Vision
- •1.3.3 Roles of Dark-Adapted Vision
- •1.3.4 A Few Remarks Regarding Visual Development
- •1.4 Prospects for Prosthetic Vision Restoration
- •References
- •2.1 Introduction
- •2.2 Retina
- •2.2.1 Anatomy
- •2.2.2 Physiology and Receptive Fields
- •2.4.1 Anatomy
- •2.4.2 Physiology and Receptive Fields
- •2.6 The Role of Spatiotemporal Edges in Early Vision
- •2.7 The Role of Corners in Early Vision
- •2.7.1 Overview
- •2.8 Effects of Fixational Eye Movements in Early Visual Physiology and Perception
- •2.8.1 Overview
- •2.8.2 Neural Adaptation and Visual Fading
- •2.8.3 Microsaccades in Visual Physiology and Perception
- •References
- •3.1 Introduction
- •3.2 Background
- •3.3 Retinal Disease and Its Diversity
- •3.4 Retinal Remodeling
- •3.5 Retinal Circuitry
- •3.6 Retinal Circuitry Revision
- •3.7 Implications for Bionic Rescue
- •3.8 Implications for Biological Rescue
- •3.9 Final Remarks
- •References
- •4.1 Introduction
- •4.4 What Are the Limits to This Cortical Plasticity?
- •4.5 Possible Mechanisms Behind Brain Plasticity
- •4.6 Modulation of Brain Plasticity: Recent Developments
- •4.7 Neuroplasticity and Other Neuroprostheses Efforts
- •4.8 A Look at What Is Ahead
- •References
- •5.1 Introduction
- •5.2 Vision Changes Experienced by RP Patients
- •5.2.1 Overview
- •5.2.2 Visual Field Loss in RP
- •5.2.3 Changes in Color Vision and Glare Sensitivity in RP
- •5.2.4 Vision Fluctuations in RP
- •5.3 Visual Changes in Patients with Advanced Macular Degeneration
- •5.3.1 Changes Due to Wet AMD or Choroidal Neovascularization
- •5.3.2 Changes Due to Dry AMD or Geographic Atrophy
- •5.4 Charles Bonnet Syndrome
- •5.4.1 Overview
- •5.4.2 Complexity of Visual Hallucinations in CBS
- •5.4.3 Predictors and Alleviating Factors for CBS
- •5.5 Filling-In Phenomena (Perceptual Completion)
- •5.6 Remapping of Primary Visual Cortex in Patients with Central Scotomas from Macular Disease
- •5.7 The Preferred Retinal Locus for Fixation
- •5.8 Photopsias
- •5.8.1 Photopsias in RP
- •5.8.2 Photopsias in AMD and Other Ocular Diseases
- •5.9 Concluding Remarks
- •References
- •6.1 Introduction
- •6.2 Electrode–Electrolyte Interface
- •6.3 Electrode Material
- •6.3.1 Electrode Characterization
- •6.4 Overview of Electrode Materials for Neural Stimulation
- •6.5 Overview of Extracellular Stimulation
- •6.6 Safe Stimulation of Tissue
- •6.6.1 Mechanisms of Neural Injury
- •6.6.2 Parameters for Safe Stimulation
- •6.6.3 Stimulation Induced Injury in the Retina
- •References
- •7.1 Introduction
- •7.2 Power and Data Transmission
- •7.2.1 Wireline Connection
- •7.2.2 Inductive Coils
- •7.2.3 Serial Optical Telemetry
- •7.2.4 Photodiode Array-Based Prostheses
- •7.2.5 Thermal Safety Considerations
- •7.2.6 Conclusions: Comparing the Different Approaches
- •7.3 Tissue Response to a Subretinal Implant
- •7.3.1 Flat Implants
- •7.3.2 Chamber Implants
- •7.3.3 Pillar Arrays
- •7.4 Damage to Retinal Tissue from Electrical Stimulation
- •7.4.1 Effect of Pulse Duration
- •7.4.2 Electrode Size
- •7.5 Concluding Remarks
- •References
- •8.1 Introduction
- •8.2 Quasistatic Numerical Methods: The Admittance Method
- •8.2.1 Layered Retinal Model
- •8.2.2 Equivalent Electric Circuit
- •8.3 Three-Dimensional Activation Function Calculation
- •8.4 Safety of Implant
- •8.5 Conclusion
- •References
- •9.1 Pathophysiology of Retinal Degeneration
- •9.2.1 Outer Plexiform Layer
- •9.2.2 Inner Plexiform Layer
- •9.2.2.1 Bipolar Cell Excitation of Retinal Ganglion Cells
- •9.2.2.2 Amacrine Cell Modulation of Signal Processing
- •9.2.2.3 Inhibitory Transmitters
- •9.2.2.4 Acetylcholine and Dopamine
- •9.2.2.5 Neuropeptides
- •9.2.2.6 Putative neurotransmitters for retinal prosthesis
- •9.3 Neurophysiological Changes in Retinal Degeneration
- •9.4 Rationale for a Neurotransmitter-Based Retinal Prosthesis
- •9.4.1 Limitations of Electrical Stimulation
- •9.5 Technical Considerations and Design Approaches
- •9.5.1 Operating Principles for a Neurotransmitter-Based Retinal Prosthesis
- •9.5.2 Establishing a Retinal Prosthesis/Synaptic Interface
- •9.5.2.1 The Proximity Requirement
- •9.5.2.2 Convective Delivery of Neurotransmitters Via Microfluidics
- •9.5.2.3 Functionalized Surfaces for Neurotransmitter Stimulation
- •9.5.2.4 Synaptic Requirements for l-Glutamate Mediated Neuronal Stimulation
- •9.6 Summary
- •References
- •10.1 Introduction
- •10.2 Pioneering Experiments
- •10.2.1 Stimulation with No Chromophores
- •10.2.2 Azo Chromophores
- •10.3 Current Research
- •10.3.1 Caged Neurotransmitters
- •10.3.2 Pore Blocker and Photoisomerization
- •10.3.3 The Channelrhodopsins
- •10.3.4 Melanopsin
- •10.4 Synthetic Chromophores and Artificial Sight
- •References
- •11.1 Background
- •11.2 Physical Structure of Intracortical Electrodes
- •11.3 Charge Injection Using Intracortical Electrodes
- •11.3.1 The Intracortical Electrode as a Transducer
- •11.3.2 Charge Injection Limits
- •11.4 Intracortical Electrode Coatings
- •11.5 Characterization of Intracortical Electrodes
- •11.5.1 Cyclic Voltammetry
- •11.5.2 Electrode Stimulation Voltage Waveforms
- •11.5.3 Non-ideal Access Resistance Behavior
- •11.5.4 Non-linear Electrode Polarization
- •11.5.5 Determining Electrode Safety
- •11.6 Contrasts of In Vitro and In Vivo Behavior
- •11.7 Alternative Coatings for Improving Intracortical Electrodes
- •11.7.1 SIROF
- •11.7.2 PEDOT
- •11.7.3 Carbon Nanotube Coatings
- •11.8 Conclusion
- •References
- •12.1 Introduction
- •12.2 Responses of RGCs to Electrical Stimulation in Normal Retina
- •12.2.1 Epiretinal Stimulation
- •12.2.1.1 Target of Stimulation
- •12.2.1.2 The Site of Spike Initiation in RGCs
- •12.2.1.3 Threshold vs. Stimulating Electrode Diameter
- •12.2.1.4 Spatial Extent of Activation
- •12.2.1.5 Selective Activation
- •12.2.1.6 Temporal Response Properties
- •12.2.2 Subretinal Stimulation
- •12.2.2.1 Target of Stimulation
- •12.2.2.2 Threshold vs. Polarity of Stimulation Pulse
- •12.2.2.3 Spatial Extent of Activation
- •12.2.2.4 Temporal Response Properties
- •12.2.2.5 Dynamics of the Retinal Response
- •12.4 Responses of RGCs to Electrical Stimulation in Degenerate Retina
- •12.4.1 Epiretinal Stimulation
- •12.4.2 Subretinal Stimulation
- •12.4.2.1 Response Properties of RGCs
- •12.4.2.2 Activation Thresholds of RGCs
- •12.5 Cortical Responses to Retinal Stimulation
- •12.5.1 Spatial Properties Revealed by Cortical Measurements
- •12.5.2 Local Field Potentials
- •12.5.3 Elicited Responses Are Focal
- •12.5.4 Cortical Measurements Reveal Electrode Interactions
- •12.5.5 Temporal Responsiveness in Cortex
- •12.6 Suggestions for Future Studies
- •References
- •13.1 Introduction
- •13.2 General Considerations for Acute Retinal Stimulation Experiments
- •13.3 Surgical Technique
- •13.4 Threshold Measurements
- •13.5 Spatial Resolution and Pattern Perception
- •13.6 Temporal Resolution
- •13.7 Subretinal Versus Epiretinal Stimulation
- •13.8 Less Invasive Stimulation Procedures
- •13.9 Conclusions and Outlook
- •References
- •14.1 Introduction
- •14.2 Overview of Chronic Retinal Implant Technologies
- •14.2.1 The Retinal Implant AG Microphotodiode Prosthesis
- •14.2.2 The Intelligent Retinal Implant System
- •14.2.3 Second Sight Medical Products, Inc. A16 System
- •14.3 Thresholds on Individual Electrodes
- •14.3.1 Single Pulse Thresholds Using the SSMP System
- •14.3.2 Pulse Train Integration and Temporal Sensitivity
- •14.4 Suprathreshold Brightness
- •14.4.1 Brightness Using the Retinal Implant AG System
- •14.4.2 Brightness Using the Intelligent Medical Implant System
- •14.4.3 Brightness Using the SSMP A16 System
- •14.5 Spatial Vision
- •14.5.1 Spatial Vision with the Retinal Implant AG System
- •14.5.2 Spatial Vision with the Intelligent Medical Implant System
- •14.5.3 Spatial Vision with the SSMP A16 System
- •14.6 Models to Guide Electrical Stimulation Protocols
- •14.7 Conclusions
- •References
- •15.1 Background
- •15.2 Cortical Surface Stimulation
- •15.3 Intracortical Microstimulation
- •15.4 Optic Nerve Stimulation
- •15.5 What Is Known and What Needs to Be Done
- •15.6 Current Research Efforts
- •15.6.1 Optic Nerve Stimulation
- •15.6.2 Cortical Surface Stimulation
- •15.6.3 Intracortical Stimulation of Visual Cortex
- •15.6.4 CORTIVIS Program
- •15.6.5 Lateral Geniculate Stimulation
- •15.7 Microelectrode Arrays and Stimulation Hardware
- •15.7.1 Miniature Cameras
- •15.7.2 Animal Models
- •15.7.3 Image Processing and Phosphene Mapping
- •15.8 Conclusion
- •References
- •16.1 Introduction
- •16.2 Simulation Techniques and Basic Parameters
- •16.2.1 Gaze Tracking and Image Stabilization
- •16.2.2 Filter Engine Parameters
- •16.2.2.1 Raster Spatial Properties
- •16.2.2.2 Dot Spatial Properties
- •16.2.2.3 Temporal Properties
- •16.2.2.4 Dynamic Background Noise
- •16.2.2.5 Input Filtering/Windowing, Image Enhancement
- •16.3 Optotype Resolution and Reading
- •16.3.1 Visual Acuity
- •16.3.2 Reading
- •16.4 Face and Object Recognition
- •16.5 Visually Guided Behavior
- •16.5.1 Hand–Eye Coordination
- •16.5.2 Wayfinding
- •16.6 Visual Tracking
- •16.7 Computational Simulations
- •16.8 Conclusion
- •References
- •17.1 Introduction
- •17.2 Situating Image Analysis
- •17.3 The Experimental Framework
- •17.4 Tracking a Low-Resolution Target
- •17.5 Discussion
- •17.6 Conclusion
- •References
- •18.1 Introduction
- •18.2 Representation of Visual Space on the Visual Cortex
- •18.3 Cortical Stimulation Studies
- •18.4 Variability in Occipital Cortex
- •18.5 Phosphene Map Estimation
- •18.6 Psychophysical Studies with the Estimated Maps
- •References
- •19.1 Importance of Mapping
- •19.3 The Computer Era: Refining the Pointing Method of Phosphene Mapping
- •19.4 Verbal Mapping
- •19.5 Mapping Studies Using Subject Drawings
- •19.6 Recent Simulation Studies Using Phosphene Mapping
- •19.6.1 Tactile Simulations at Shanghai Jiao Tong University
- •19.6.2 Simulations in Our Laboratory
- •19.7 Concluding Remarks on Phosphene Mapping Techniques
- •References
- •20.1 Introduction
- •20.2 Principles for Assessment of Prosthetic Vision
- •20.2.1 Experimental Design
- •20.2.2 The Importance of Pre-operative Testing
- •20.2.3 Post-operative Assessment
- •20.2.4.1 Potential Approaches
- •20.2.4.2 Avoidance of Bias
- •20.2.4.3 Criteria for Sound Testing
- •20.2.4.4 Forced Choice Procedures
- •20.2.4.5 Response Time
- •20.2.4.6 Task (Perceptual) Learning
- •20.2.4.7 Establishing Criteria for Meaningful Change
- •20.2.4.8 Light Level
- •20.3 Vision Assessment in Prosthesis Recipients: Overview
- •20.3.1 Visual Function Assessment: Overview
- •20.3.2 Visual Performance Assessment: Overview
- •20.3.2.1 Measured Visual Performance
- •20.3.2.2 Self-Reported Visual Performance
- •20.4 Visual Function Assessment
- •20.4.1 Candidate Measures
- •20.4.1.1 Contrast Sensitivity (Contrast Detection)
- •20.4.1.2 Contrast Discrimination
- •20.4.1.3 Motion Perception
- •20.4.1.4 Depth Perception
- •20.4.2 Tests Used in Prosthesis Trials
- •20.4.3 Tests that Have Been Designed for Use with Prostheses
- •20.4.4 Vision Tests for Very Low Vision
- •20.5 Visual Performance Assessment
- •20.5.1 Measured Performance
- •20.5.2 Self-Reported Performance (Questionnaires)
- •20.6 Summary
- •References
- •21.1 Concepts of Functional Vision and Rehabilitation
- •21.1.1 Application to Orientation and Mobility
- •21.1.2 Application for Activities of Daily Living
- •21.1.3 Patient Lifestyle and Expectations
- •21.1.4 Congenital and Adventitious Vision Loss
- •21.2 Evaluation and Intervention with Prosthetic Vision
- •21.2.1 Evaluation
- •21.2.2 Intervention
- •21.3 Measuring Functional Outcomes
- •21.4 The Future
- •References
- •Author Index
- •Subject Index
17 Image Analysis, Information Theory and Prosthetic Vision |
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the observer which 1/32 of the area covered by the phosphene array contains the target. In this latter case, we would expect the observer to deviate from the target by less than that amount; the mean deviation would be reduced by approximately a factor of 4 (rather than 16, since the field is two-dimensional).
17.5 Discussion
We have reviewed two studies of ours that address image analysis, its use in microelectronic retinal prostheses, and the perception of low-resolution images. These studies form the beginning of an approach that integrates theory and experiment and aims to better constrain the design of a prosthesis. Effectively, the approach seeks to answer the question, “How should high-resolution images be analyzed before rendering phosphene images?”
In our psychophysical experiments, subjects fixated and pursued a small, moving target that was rendered on an array of phosphenes [8]. There, we showed that image analysis, which converts the high-resolution image of the moving target to the phosphene image, can indeed be used to improve subjects’ performance. During trials, subjects scanned the phosphene array over the target, using some phosphenes in preference to others. We modeled this scanning using a bivariate function, and we termed this model the “artificial preferred retinal locus” (APRL). The experiments in [6] were numerical. There, we used the APRL in conjunction with various image analysis schemes and measured the information contained in the phosphene image. We found that the scheme affording subjects the best tracking performance imparted the most information to the phosphene image. Further, we found an optimal scheme of Gaussian kernels for image analysis which we predict would afford further improvements in performance.
Our approach contributes to the existing literature on image analysis, its use in microelectronic retinal prosthesis, and the perception of low-resolution images. We have established an exchange between information theory and visual modeling, that is, the simulation of prosthetic vision using normal observers. This exchange allows for the design and implementation of image analysis schemes on the basis of quantitative reasoning, and for those schemes to be verified via psychophysical methods. For example, our numerical experiment predicts that the optimal Gaussian scheme for fixation and pursuit involves kernels with standard deviation equal to 0.6 times the phosphene-to-phosphene spacing [6]. This prediction may be tested in a visual modeling experiment, prior to a test in actual implantees who are capable of performing simple visual tasks. Alternative approaches to image analysis often simply cite “biological inspiration.” For example, an edge-detection scheme is often thought to be justified because edges are known to be of particular salience to the visual system. These approaches may have merit, but the design of the image analysis scheme seems arbitrary, and usually is not tested using visual modeling.
It is important to consider the computational cost of an image analysis scheme. For our purposes, the operation of a kernel on an image involves A real multiplications
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and A − 1 real additions, where A is the area of the kernel in pixels. Therefore, the relative cost of image analysis scheme Q2 is proportional to the area of the Q2 kernel divided by that of the Q1 kernel. In many image processing applications, Gaussian kernels are restricted to a circular support with a radius of three standard deviations. Our circular averaging kernels (Q1) had a diameter equal to the separation of phosphenes. Therefore, the ratio of areas of these kernels is 3.24. That is, in our tracking study [8], the computational cost of using Q2 was 3.24 times that of Q1.
So far, our approach involves models of scanning that vary in space, but not time. However, scanning is likely to be better described by models that are spatiotemporal. A spatiotemporal model of scanning would describe not only which phosphenes were used in preference to others, but how the outputs of many phosphenes were used in combination over time. In other words, a spatiotemporal scanning model would describe how subjects tended to sweep the phosphene array across the high-resolution target. Our psychophysical data suggest that the temporal nature of scanning is important (see also [3]). For example, the image analysis scheme Q0 compelled subjects to use nystagmus-like scanning, rapidly moving the array back and forth across the underlying target. Rather than using the information contained in the phosphene image at a single instant, subjects integrated the phosphene array activity over short periods, and used that integrated information to guide behavior. Developing scanning models, that is, APRLs, to include secondand higher-order statistics is the subject of ongoing work.
Our approach concerns visual fixation and pursuit. In the future, we aim to extend the approach to include other tasks, such as reading. To do so, our psychophysical experiment [8] could be modified to involve the identification of commonly used words, as opposed to the tracking of a small, moving target. In this new experiment, subjects would employ scanning behaviors that were specific to reading. Then, images of these commonly used words could be used as stimuli in the numerical set-up of [6], and an image analysis scheme could be tailored to these images. Overall, it is likely that different image analysis schemes would apply to different visual tasks. For example, a Gaussian scheme, like Q2, may be suited to tracking a small, moving target, but some other scheme involving some other class of kernels may be better suited to reading, for example, oriented Gabor functions.
17.6 Conclusion
We have discussed our approach to image analysis, microelectronic retinal prostheses, and the perception of low-resolution images. We believe that this approach can be used to help constrain the design of an implant. The approach is analogous to the acoustic modeling of cochlear implants which involves normally hearing listeners. That approach has made important contributions to the improvement of clinical outcomes in cochlear implantees since 1990. We hope that our visual modeling approach, and developments thereof, will ultimately contribute to improved clinical outcomes in retinal implantees.
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Acknowledgments We thank Shaun Cloherty for comments on an early draft of the manuscript.
References
1.Blahut RE (1987), Principles and practice of information theory. Addison-Wesley: Norwood, MA.
2.Cha K (1992), Functional capabilities with a pixelized vision system: application to visual prosthesis. PhD dissertation, University of Utah.
3.Chen SC, Hallum LE, Suaning GJ, Lovell NH (2007), A quantitative analysis of head movement behaviour during visual acuity assessment under prosthetic vision simulation. J Neural Eng 4: p. S108–S123.
4.Dowling J (2005), Artificial human vision. Expert Rev Med Devices 2: p. 73–85.
5.Fornos AP, Sommerhalder J, Rappaz B, et al. (2005), Simulation of artificial vision, III: do the spatial or temporal characteristics of stimulus pixelization really matter? Invest Ophthalmol Vis Sci 46: p. 3906–3912.
6.Hallum LE, Cloherty SL, Lovell NH (2008), Image analysis for microelectronic retinal prosthesis. IEEE Trans Biomed Eng 55: p. 344–346.
7.Hallum LE, Dagnelie G, Suaning GJ, Lovell NH (2007), Simulating auditory and visual sensorineural prostheses: a comparative review. J Neural Eng 4: p. S58–S71.
8.Hallum LE, Suaning GJ, Taubman DS, Lovell NH (2005), Simulated prosthetic visual fixation, saccade, and smooth pursuit. Vision Res 45: p. 775–788.
9.Rubinstein JT, Miller CA (1999), How do cochlear prostheses work? Curr Opin Neurobiol 9: p. 399–404.
10. Thompson, Jr., RW, Barnett GD, Humayun MS, Dagnelie G (2003), Facial recognition using simulated prosthetic pixelized vision. Invest Ophthalmol Vis Sci 44: p. 5035–5042.
11. Timberlake GT, Mainster MA, Peli E, et al. (1986), Reading with a macular scotoma. I. Retinal location of scotoma and fixation area. Invest Ophthalmol Vis Sci 27: p. 1137–1147.
Chapter 18
Simulations of Cortical Prosthetic Vision
Nishant R. Srivastava
Abstract Cortical stimulation for restoring vision presents researchers with many challenges and questions. The extent of the human visual cortex varies up to 50% from one individual to another, cortical folding and sulci limit the area of implantation, and surgical difficulties make it difficult to implant electrodes to produce phosphenes in the whole visual space. Researchers are faced with question such as: which electrodes to use – surface electrodes that are easy to implant or intracortical fine-metal electrodes that have lower current requirements and have five times better resolution? How many phosphenes will be enough to give limited, but useful vision? How will cortical physiology affect phosphene maps? Will percepts be distinct dots or complex in nature? What will be the long term response to stimulation? Will the brain adapt to seeing through dotted images? Some of these questions can be answered by conducting human psychophysical tests.
Abbreviations
f MRI |
functional Magnetic resonance imaging |
LGN |
Lateral geniculate nucleus |
V1 |
Striate cortex or primary visual cortex |
V2 |
Prestriate cortex or secondary visual cortex |
V3 |
Third visual complex |
18.1 |
Introduction |
In the 1990s, Cha et al. simulated arrays varying from 100 electrodes (10 × 10 arrays) to 1,024 electrodes (32 × 32 arrays), represented by small dots in a video display mounted on ski goggles to test the requirements of a cortical prosthesis
N.R. Srivastava (*)
Department of Biomedical Engineering, Pritzker Institute of Biomedical Science and Engineering, Illinois Institute of Technology, 3255 S. Dearborn, WH 314, Chicago, IL 60616, USA e-mail: srivnis@gmail.com
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DOI 10.1007/978-1-4419-0754-7_18, © Springer Science+Business Media, LLC 2011 |
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