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PurposeVisual prosthetics are a promising assistive technology for vision loss, yet research often overlooks the human aspects of this technology. While previous studies focus on the perceptual experiences or attitudes of implant recipients (implantees), a systematic account of how current implants are being used in everyday life is still lacking.MethodsWe interviewed six recipients of the most widely used visual implants (Argus II and Orion) and six leading researchers in the field. Through thematic analyses, we explored the daily usage of these implants by implantees and compared their responses to the expectations of researchers. We also sought implantees' input on desired features for future versions, aiming to inform the development of the next generation of implants.ResultsAlthough implants are designed to facilitate various daily activities, we found that implantees use them less frequently than researchers expect. This discrepancy primarily stems from issues with usability and reliability, with implantees finding alternative methods to accomplish tasks, reducing the need to rely on the implant. For future implants, implantees emphasized the desire for improved vision, smart integration, and increased independence.ConclusionsOur study reveals a significant gap between researcher expectations and implantee experiences with visual prostheses. Although limited by access to a small population of implantees, this study highlights the importance of focusing future research on usability and real-world applications.Translational relevanceThis retrospective qualitative study advocates for a better alignment between technology development and implantee needs to enhance clinical relevance and practical utility of visual prosthetics.

Objective.How can we return a functional form of sight to people who are living with incurable blindness? Despite recent advances in the development of visual neuroprostheses, the quality of current prosthetic vision is still rudimentary and does not differ much across different device technologies.Approach.Rather than aiming to represent the visual scene as naturally as possible, aSmart Bionic Eyecould provide visual augmentations through the means of artificial intelligence-based scene understanding, tailored to specific real-world tasks that are known to affect the quality of life of people who are blind, such as face recognition, outdoor navigation, and self-care.Main results.Complementary to existing research aiming to restore natural vision, we propose a patient-centered approach to incorporate deep learning-based visual augmentations into the next generation of devices.Significance.The ability of a visual prosthesis to support everyday tasks might make the difference between abandoned technology and a widely adopted next-generation neuroprosthetic device.

This study presents phosphenotron, a device for enhancing the sensory spatial resolution of phosphenes in the visual field (VF). The phosphenotron employs a non-invasive transcranial alternating current stimulation (NITACS) to modulate brain activity by applying weak electrical currents to the scalp or face. NITACS's unique application induces phosphenes, a phenomenon where light is perceived without external stimuli. Unlike previous invasive methods, NITACS offers a non-invasive approach to create these effects. The study focused on assessing the spatial resolution of NITACS-induced phosphenes, crucial for advancements in visual aid technology and neuroscience. Eight participants were subjected to NITACS using a novel electrode arrangement around the eye orbits. Results showed that NITACS could generate spatially defined phosphene patterns in the VF, varying among individuals but consistently appearing within their VF and remaining stable through multiple stimulations. The study established optimal parameters for vibrant phosphene induction without discomfort and identified electrode positions that altered phosphene locations within different VF regions. Receiver Operating characteristics analysis indicated a specificity of 70.7%, sensitivity of 73.9%, and a control trial accuracy of 98.4%. These findings suggest that NITACS is a promising, reliable method for non-invasive visual perception modulation through phosphene generation. [ABSTRACT FROM AUTHOR]

Bionic vision systems are currently limited by indiscriminate activation of all retinal ganglion cells (RGCs)– despite the dozens of known RGC types which each encode a different visual message. Here, we use spike-triggered averaging to explore how electrical responsiveness varies across RGC types toward the goal of using this variation to create type-selective electrical stimuli. A battery of visual stimuli and a randomly distributed sequence of electrical pulses were delivered to healthy and degenerating (4-week-old rd10) mouse retinas. Ganglion cell spike trains were recorded during stimulation using a 60-channel microelectrode array. Hierarchical clustering divided the recorded RGC populations according to their visual and electrical response patterns. Novel electrical stimuli were presented to assess type-specific selectivity. In healthy retinas, responses fell into 35 visual patterns and 14 electrical patterns. In degenerating retinas, responses fell into 12 visual and 23 electrical patterns. Few correspondences between electrical and visual response patterns were found except for the known correspondence of ON visual type with upward deflecting electrical type and OFF cells with downward electrical profiles. Further refinement of the approach presented here may yet yield the elusive nuances necessary for type-selective stimulation. This study greatly deepens our understanding of electrical input filters in the context of detailed visual response characterization and includes the most complete examination yet of degenerating electrical input filters.

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Background: In this study, we aimed to report the short-term (6 months) effects on visual functionality and safety of femto-laser assisted smaller-incision new-generation implantable miniature telescope (SING-IMT™) implanting, particularly related to postsurgical intraocular pressure increase, in patients suffering from end-stage age-related macular degeneration (AMD) and cataract. This device, designed for monocular use, aims to minimise the impact of the central scotoma by projecting the images onto a larger area of the photoreceptors surrounding the macula. Methods: In this prospective multicentric observational case series study, 6 eyes of 6 patients who underwent SING-IMT™ implantations were enrolled. At baseline and 6 months follow-up, best corrected distance visual acuity (BCDV) and best corrected near visual acuity (BCNVA), intraocular pressure (IOP), anterior chamber depth, endothelial cells count were assessed. In addition, IOP was also measured at 7, 15, 30, 45 days, and at 3 months follow-up. Finally, the incidence of complications was evaluated. Results: At final follow-up, in the study eyes, mean BCDVA improved by +10.0 letters (6.25; 13.8) letters and mean BCNVA improved by −0.30 logMAR (−0.55; −0.20). At postoperative month 6, we reported a mean IOP decrease of 4.50 mmHg (−5.75; −0.25). Interestingly, 83.3% of patients had an increased IOP value in at least one of the first two postoperative follow-ups (7 days and 15 days). In patients in whom intraoperative mechanical iridotomy was not performed, it was necessary to perform a postoperative YAG laser iridotomy to improve IOP management. Compared to the baseline, ECD loss at 6 months follow-up was 12.6%. Conclusions: The SING IMT™ device was found to be effective in the distance and near vision improvement, without serious postoperative complications. We recommend intraoperative mechanical iridectomy in order to easily manage post-operative IOP and to avoid sudden IOP rise with its possible consequences. These good results can be a hope to partially improve the quality of life of patients suffering from severe end stage macular atrophy. [ABSTRACT FROM AUTHOR]

Bionic vision systems are currently limited by indiscriminate activation of all retinal ganglion cells (RGCs)– despite the dozens of known RGC types which each encode a different visual message. Here, we use spike-triggered averaging to explore how electrical responsiveness varies across RGC types toward the goal of using this variation to create type-selective electrical stimuli. A battery of visual stimuli and a randomly distributed sequence of electrical pulses were delivered to healthy and degenerating (4-week-old rd10) mouse retinas. Ganglion cell spike trains were recorded during stimulation using a 60-channel microelectrode array. Hierarchical clustering divided the recorded RGC populations according to their visual and electrical response patterns. Novel electrical stimuli were presented to assess type-specific selectivity. In healthy retinas, responses fell into 35 visual patterns and 14 electrical patterns. In degenerating retinas, responses fell into 12 visual and 23 electrical patterns. Few correspondences between electrical and visual response patterns were found except for the known correspondence of ON visual type with upward deflecting electrical type and OFF cells with downward electrical profiles. Further refinement of the approach presented here may yet yield the elusive nuances necessary for type-selective stimulation. This study greatly deepens our understanding of electrical input filters in the context of detailed visual response characterization and includes the most complete examination yet of degenerating electrical input filters. [ABSTRACT FROM AUTHOR]

Retinal neuroprostheses are the only FDA-approved treatment option for blinding degenerative diseases. A major outstanding challenge is to develop a computational model that can accurately predict the elicited visual percepts (phosphenes) across a wide range of electrical stimuli. Here we present a phenomenological model that predicts phosphene appearance as a function of stimulus amplitude, frequency, and pulse duration. The model uses a simulated map of nerve fiber bundles in the retina to produce phosphenes with accurate brightness, size, orientation, and elongation. We validate the model on psychophysical data from two independent studies, showing that it generalizes well to new data, even with different stimuli and on different electrodes. Whereas previous models focused on either spatial or temporal aspects of the elicited phosphenes in isolation, we describe a more comprehensive approach that is able to account for many reported visual effects. The model is designed to be flexible and extensible, and can be fit to data from a specific user. Overall this work is an important first step towards predicting visual outcomes in retinal prosthesis users across a wide range of stimuli.

Vision loss from diseases of the outer retina, such as age-related macular degeneration, is among the leading causes of irreversible blindness in the world today. The goal of retinal prosthetics is to replace the photo-sensing function of photoreceptors lost in these diseases with optoelectronic hardware to electrically stimulate patterns of retinal activity corresponding to vision. To enable high-resolution retinal prosthetics, the scale of stimulating electrodes must be significantly decreased from current designs; however, this reduces the amount of stimulating current that can be delivered. The efficacy of subretinal stimulation at electrode sizes suitable for high visual acuity retinal prosthesis are not well understood, particularly within the safe charge injection limits of electrode materials. Here, we measure retinal ganglion cell (RGC) responses in a mouse model of blindness to evaluate the stimulation efficacy of 10, 20, and 30 μm diameter iridium oxide electrodes within the electrode charge injection limits, focusing on measures of charge threshold and dynamic range. Stimulation thresholds were lower for smaller electrodes, but larger electrodes could elicit a greater dynamic range of spikes and recruited more ganglion cells within charge injection limits. These findings suggest a practical lower limit for planar electrode size and indicate strategies for maximizing stimulation thresholds and dynamic range.

Argus II is the most advanced retina implants approved by the US FDA and almost 350 visually impaired people are using it. This implant uses 60 microelectrodes implanted in the retina. The goal of this implant is to improve mobility and quality of life of its users. However, users’ satisfaction is not very high due to the very low resolution of the phosphene images and features created by this device. This article proposes a system to improve the artificial vision created by visual implants. The proposed method extracts information about the people around the visually impaired person by using image processing and machine vision algorithms. This information includes the number of the people in the scene, whether they are known or unknown, their gender, estimated ages, facial emotions, and approximate distance from the visually impaired person. This information is extracted from the frames received by a camera mounted on the glasses of the user to generate signals that are fed into a visual stimulator. This information is shown to the user by a schematic vision created by some pre-trained patterns of phosphenes reflecting the information communicated to the user. The proposed system is validated with a simulated prosthetic vision comprising 150 microelectrodes that is compatible with the retina and visual cortex implants. A low-cost and energy efficient implementation of the proposed method executing on a Raspberry Pi 4 B at a frame rate of 4.5 frames/second shows the feasibility of using it in portable systems.

PurposeTo present a perspective on the use of electrotherapeutics in the history of ophthalmology along with the development of novel contemporary ophthalmic instrumentation.DesignPerspective study.MethodsWe reviewed historical journals, articles, and books discussing the use of electricity and electrotherapeutics in ophthalmology.ResultsElectrotherapeutic applications have been researched and used to treat ocular diseases as far back as the 18th century. By the 20th century, research in electrotherapeutics in ophthalmology had caught the eye of Edward Jackson, the first president of the American Academy of Ophthalmology and Otolaryngology and first editor of the present (third) series American Journal of Ophthalmology. Edward Jackson published an extensive review on this topic and reported a variety of modalities used to treat ocular diseases.ConclusionsWhile many early therapeutic uses of electricity did not produce effective and replicable results, studies on electrical stimulation of the eye provided the foundation for the development of clinically significant vision enhancing and restoring instrumentation.

Age-related macular degeneration (AMD) causes severe vision impairments, including blindness. An option to improve vision in AMD patients is through intraocular lenses and optics. Among others, implantable miniaturized telescopes, which direct light to healthy lateral regions of the retina, can be highly effective in improving vision in AMD patients. Yet, the quality of the restored vision might be sensitive to the optical transmission and aberrations of the telescope. To shed light on these points, we studied the in vitro optical performance of an implantable miniaturized telescope, namely, the SING IMT™ (Samsara Vision Ltd., Far Hills, NJ, USA) designed to improve vision in patients affected by late-stage AMD. Specifically, we measured the optical transmission in the spectral range 350–750 nm of the implantable telescope with a fiber-optic spectrometer. Wavefront aberrations were studied by measuring the wavefront of a laser beam after passing through the telescope and expanding the measured wavefront into a Zernike polynomial basis. Wavefront concavity indicated that the SING IMT™ behaves as a diverging lens with a focal length of −111 mm. The device exhibited even optical transmission in the whole visible spectrum and effective curvature suitable for retinal images magnification with negligible geometrical aberrations. Optical spectrometry and in vitro wavefront analysis provide evidence supporting the feasibility of miniaturized telescopes as high-quality optical elements and a favorable option for AMD visual impairment treatments. [ABSTRACT FROM AUTHOR]

Degenerative retinal diseases such as retinitis pigmentosa and macular degeneration cause irreversible vision loss in more than 10 million people worldwide. Retinal prostheses, now implanted in over 250 patients worldwide, electrically stimulate surviving cells in order to evoke neuronal responses that are interpreted by the brain as visual percepts ('phosphenes'). However, instead of seeing focal spots of light, current implant users perceive highly distorted phosphenes that vary in shape both across subjects and electrodes. We characterized these distortions by asking users of the Argus retinal prosthesis system (Second Sight Medical Products Inc.) to draw electrically elicited percepts on a touchscreen. Using ophthalmic fundus imaging and computational modeling, we show that elicited percepts can be accurately predicted by the topographic organization of optic nerve fiber bundles in each subject's retina, successfully replicating visual percepts ranging from 'blobs' to oriented 'streaks' and 'wedges' depending on the retinal location of the stimulating electrode. This provides the first evidence that activation of passing axon fibers accounts for the rich repertoire of phosphene shape commonly reported in psychophysical experiments, which can severely distort the quality of the generated visual experience. Overall our findings argue for more detailed modeling of biological detail across neural engineering applications.

PurposeFor more than 20 years, there has been an international, multidisciplinary effort to develop retinal prostheses to restore functional vision to patients blinded by retinal degeneration. We developed a novel subretinal prosthesis with 1512 optically addressed silicon nanowire photodiodes, which transduce incident light into an electrical stimulation of the remaining retinal circuitry. This study was conducted to evaluate the efficacy of optically driving the subretinal prosthesis to produce visual cortex activation via electrical stimulation of the retina.MethodsWe measured electrically evoked potential responses (EEPs) in rabbit visual cortex in response to illumination of the subretinal nanowire prosthesis with pulsed 852-nm infrared (IR) light. We compared the EEP responses to visually evoked potential responses (VEPs) to pulsed 532-nm visible light (positive control) and pulsed 852-nm IR light (negative control).ResultsActivating the devices with IR light produced EEP responses with a significantly higher trough-to-peak amplitude (54.17 ± 33.4 μV) than IR light alone (24.07 ± 22.1 μV) or background cortical activity (23.22 ± 17.2 μV). EEP latencies were significantly faster than focal VEP latencies. Focal VEPs produced significantly higher amplitudes (94.88 ± 43.3 μV) than EEPs. We also demonstrated how an electrode placed on the cornea can be used as a noninvasive method to monitor the function of the implant.ConclusionsThese results show that subretinal electrical stimulation with nanowire electrodes can elicit EEPs in the visual cortex, providing evidence for the viability of a subretinal nanowire prosthetic approach for vision restoration.

The smaller-incision new-generation implantable miniature telescope (SING IMT™) is the second generation of the IMT™, a telescope prosthesis that is indicated for monocular implantation in patients with stable vision impairment caused by bilateral central scotomas associated with end-stage Age-related macular degeneration (AMD). This non-comparative retrospective study is the first and largest single-surgeon case series to evaluate the short-term (3 months) safety and efficacy of the device in patients with disciform scars or geographic atrophy at baseline. The main outcome measures included best-corrected distance and near visual acuity (CDVA and CDNVA, respectively), endothelial cell density (ECD) loss, and the incidence of complications. At postoperative month 3 in the study eyes, mean CDVA and CDNVA improved by +14.9 ± 7.1 letters and +7.7 ± 3.2 Jaeger levels, respectively. Importantly, 70.83% of patients gained ≥ 2 lines, 58.33% ≥ 3 lines, and 25.00% ≥ 4 lines of CDVA. From baseline, ECD loss in the study eyes was 10.4 ± 13.3% at 3 months, however, ECD was comparable between the study and fellow eyes at all time points. The most common complication was corneal edema. In all, these short-term outcomes suggest that the SING IMT™ delivers lower ECD loss than the first-generation IMT ™, but similar visual outcomes and safety. [ABSTRACT FROM AUTHOR]

The human retina is a fragile and sophisticated light-sensitive tissue in the central nervous system. Unhealthy retinas can cause irreversible visual deterioration and permanent vision loss. Effective therapeutic strategies are restricted to the treatment or reversal of these conditions. In recent years, nanoscience and nanotechnology have revolutionized targeted management of retinal diseases. Pharmaceuticals, theranostics, regenerative medicine, gene therapy, and retinal prostheses are indispensable for retinal interventions and have been significantly advanced by nanomedical innovations. Hence, this review presents novel insights into the use of versatile nanomaterial-based nanocomposites for frontier retinal applications, including non-invasive drug delivery, theranostic contrast agents, therapeutic nanoagents, gene therapy, stem cell-based therapy, retinal optogenetics and retinal prostheses, which have mainly been reported within the last 5 years. Furthermore, recent progress, potential challenges, and future perspectives in this field are highlighted and discussed in detail, which may shed light on future clinical translations and ultimately, benefit patients with retinal disorders., Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: All authors consent to this publication. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Purpose: In the treatment of blindness causing retinal dystrophies, that is, retinitis pigmentosa (RP), retinal implants showed promising results. Recently, larger devices restoring a greater visual field were introduced. With larger size, implantation surgery became more difficult. In this study, a novel implantation device was developed, fabricated, and tested in implantation surgeries. The goal was to demonstrate a reproducible, safe, and, in comparison, superior implantation method., Methods: The novel implantation device 3D-Printed Large-Array Port-System (3D-PLAPS) was designed using computer-aided design software. Anatomic dimensions of rabbit, pig, and human eyes were collected from anatomic and histological data sources. The 3D-PLAPS were 3D-printed. In cadaveric porcine and rabbit eyes, 3D-PLAPS was used to implant large epiretinal stimulators developed by this group. A standardized surgical procedure was established. Intraocular pressure (IOP) was measured., Results: The 3D-PLAPS implantation device was designed with a length of 8.4 mm and adapted to the curvature of normal sighted human eyes with a diameter of 24.0 mm. The elliptical aperture is 7.0 mm in length and 1.0 mm in width at its widest points. Marginal apertures for scleral fixation were added. A closing plug was introduced. Design and dimensions were adapted for rabbit eyes. During surgery, the 3D-PLAPS improved ocular stability, sealed the incision, and withstood an elevated IOP. It was suitable for foldable stimulators with a diameter of up to 14.0 mm., Conclusions: The 3D-PLAPS implantation device showed feasibility in implantation of large epiretinal stimulators and possibly also facilitates repositioning of stimulating arrays in acute experiments without the necessity for additional surgical steps., Translational Relevance: The 3D printing and CAD software are used to applied surgery for large epiretinal stimulators.

Purpose: To develop and evaluate a photovoltaic, wireless wide-field epiretinal prosthesis for the treatment of retinitis pigmentosa., Methods: A mosaic array of thinned silicon-based photodiodes with integrated thin-film stimulation electrodes was fabricated with a flexible polyimide substrate film to form a film-based miniaturized electronic system with wireless optical power and signal transmission and integrated electrostimulation. Manufactured implants were characterized with respect to their optoelectronic performance and biocompatibility following DIN EN ISO 10993., Results: A 14 mm diameter prosthesis containing 1276 pixels with a maximum sensitivity at a near infrared wavelength of 905 nm and maximized stimulation current density 30-50 μm below the electrodes was developed for direct activation of retinal ganglion cells during epiretinal stimulation. Fabricated prostheses demonstrated mucosal tolerance and the preservation of both metabolic activity, proliferation and membrane integrity of human fibroblasts as well as the retinal functions of bovine retinas. Illumination of the prosthesis, which was placed epiretinally on an isolated perfused bovine retina, with infrared light resulted in electrophysiological recordings reminiscent of an a-wave (hyperpolarization) and b-wave (depolarization)., Conclusions: A photovoltaic, wireless wide-field epiretinal prosthesis for the treatment of retinitis pigmentosa using near infrared light for signal transmission was designed, manufactured and its biocompatibility and functionality demonstrated in vitro and ex vivo., (© 2024 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)

Objective. Development of cortical visual prostheses requires optimization of evoked responses to electrical stimulation to reduce charge requirements and improve safety, efficiency, and efficacy. One promising approach is timing stimulation to the local field potential (LFP), where action potentials have been found to occur preferentially at specific phases. To assess the relationship between electrical stimulation and the phase of the LFP, we recorded action potentials from primary (V1) and secondary (V2) visual cortex in marmosets while delivering single-pulse electrical microstimulation at different phases of the LFP. Approach. A 64-channel 4 shank probe was inserted into V1 and V2. Microstimulation (single biphasic pulse, 10 µ A and 200 µ s per phase) was applied to selected channels in V1, and action potentials recorded simultaneously in V1 and V2. Microstimulation pulses were jittered in time to randomize the phase of the LFP at the time of stimulation. Results. We found frequency-specific phase modulation in a subset of units, where microstimulation in V1 evokes a higher firing rate in both V1 and V2 when delivered at specific phases of the LFP. We characterize phase modulation in terms of the preferred phase and frequency of V1 stimulation for responses in both V1 and V2, and effect size as a function of phase estimation accuracy. Significance. Phase modulation could reduce charge requirements for neural activation, reducing the volume of activated tissue and improving the safety, efficacy, and specificity of cortical visual prostheses. Phase modulation could allow cortical visual prostheses to stimulate using more simultaneous electrodes, with improved neural specificity, and, potentially, targeting downstream cortical activation., (Creative Commons Attribution license.)

Neuroprosthetics equipped with artificial synapses hold promise to address some most intricate medical problems, such as human sensory disorders. Yet, it is necessitated and of paramount importance for neuroprosthetics to be able to differentiate significant and insignificant signals. Here, we present an information-filterable artificial retina system that integrates artificial synapses with a signal-integration device for signal perception and processing with attention. The synaptic weight modulation is rendered through metal-organic framework (MOF) layers, where distinct short-term and long-term properties are predominantly determined by MOF's pore diameter and functionality. Specifically, four types of isoreticular Zr-based MOFs that share Zr 6 O 4 (OH) 4 secondary building units have been systematically examined. It is demonstrated that small pore diameters enhance short-term properties, while large pores, which are characterized by increased ion affinity, sustain long-term properties. Moreover, we demonstrated a 6 × 6 pixel artificial retina by incorporating both short-term and long-term artificial synapses with a signal-integration device. Signal summation by the signal-integration device enables attention-based information processing. The information-filterable artificial retina system developed here emulates human perception processes and holds promise in the fields of neuroprosthetics and advanced artificial intelligence., Competing Interests: Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Introduction: Current brain-based visual prostheses pose significant challenges impeding adoption such as the necessarily complex surgeries and occurrence of more substantial side effects due to the sensitivity of the brain. This has led to much effort toward vision restoration being focused on the more approachable part of the brain - the retina. Here we introduce a novel, parameterised simulation platform that enables study of human retinal degeneration and optimization of stimulation strategies. The platform bears immense potential for patient-specific tailoring and serves to enhance artificial vision solutions for individuals with visual impairments., Material and Method: Our virtual retina is developed using the software package, NEURON. This virtual retina platform supports large-scale simulations of over 10,000 neurons whilst upholding strong biological plausibility with multiple important visual pathways and detailed network properties. The comprehensive three-dimensional model includes photoreceptors, horizontal cells, bipolar cells, amacrine cells, and midget and parasol retinal ganglion cells, with comprehensive network connectivity across various eccentricities (1 mm-5 mm from the fovea) in the human retina. The model is constructed using electrophysiology, immunohistology, and optical coherence tomography imaging data from healthy and degenerate human retinas. We validated our model by replicating numerous experimental observations from human and primate retina, with a particular focus on retinal degeneration., Result: We simulated interactions between diseased retinas and state-of-the-art retinal implants, shedding light on the limitations of commercial retinal prostheses. Our results suggested that appropriate stimulation settings with intraretinal prototype devices could leverage network-mediated activation to achieve activation mosaics more alike that of the retina's response to natural light, promoting the prospect of more naturalistic vision. Our study additionally highlights the importance of controlling inhibitory circuits in the retinal network to induce functionally relevant retinal activity., Conclusion: This study demonstrates the potential of this software package and highlights its utility as a valuable tool for engineers, scientists, and clinicians in the design and optimization of retinal stimulation devices for both research and educational applications., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Keith Ly reports financial support was provided byAustralian Government Research Training Program and HDR Completion Scholarships. Michael L. Italiano reports financial support was provided byAustralian Government Research Training Program and HDR Completion Scholarships. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 The Authors. Published by Elsevier Inc. All rights reserved.)

Brain-Machine Interfaces (BMI) offer the potential to modulate dysfunctional neurological networks by electrically stimulating the cerebral cortex via chronically-implanted microelectrodes. Wireless transmitters worn by BMI recipients must operate within electromagnetic emission and tissue heating limits, such as those prescribed by the IEEE and International Commission on Non-Ionizing Radiation Protection (ICNIRP), to ensure that radiofrequency emissions of BMI systems are safe. Here, we describe an approach to generating pre-compliance safety data by simulating the Specific Absorption Rate (SAR) and tissue heating of a multi-layered human head model containing a system of wireless, modular BMIs powered and controlled by an externally worn telemetry unit. We explore a number of system configurations such that our approach can be utilized for similar BMI systems, and our results provide a benchmark for the electromagnetic emissions of similar telemetry units. Our results show that the volume-averaged SAR per 10g of tissue exposed to our telemetry field complies with ICNIRP and IEEE reference levels, and that the maximum temperature increase in tissues was within permissible limits. These results were unaffected by the number of implants in the system model, and therefore we conclude that the electromagnetic emissions our BMI in any configuration are safe.

Ultrasound neuromodulation is an emerging technology. A significant amount of effort has been devoted to investigating the feasibility of noninvasive ultrasound retinal stimulation. Recent studies have shown that ultrasound can activate neurons in healthy and degenerated retinas. Specifically, high-frequency ultrasound can evoke localized neuron responses and generate patterns in visual circuits. In this review, we recapitulate pilot studies on ultrasound retinal stimulation, compare it with other neuromodulation technologies, and discuss its advantages and limitations. An overview of the opportunities and challenges to develop a noninvasive retinal prosthesis using high-frequency ultrasound is also provided. [ABSTRACT FROM AUTHOR]

The 'bionic eye'-so long a dream of the future-is finally becoming a reality with retinal prostheses available to patients in both the US and Europe. However, clinical experience with these implants has made it apparent that the visual information provided by these devices differs substantially from normal sight. Consequently, the ability of patients to learn to make use of this abnormal retinal input plays a critical role in whether or not some functional vision is successfully regained. The goal of the present review is to summarize the vast basic science literature on developmental and adult cortical plasticity with an emphasis on how this literature might relate to the field of prosthetic vision. We begin with describing the distortion and information loss likely to be experienced by visual prosthesis users. We then define cortical plasticity and perceptual learning, and describe what is known, and what is unknown, about visual plasticity across the hierarchy of brain regions involved in visual processing, and across different stages of life. We close by discussing what is known about brain plasticity in sight restoration patients and discuss biological mechanisms that might eventually be harnessed to improve visual learning in these patients.

Background: Restoring sight for the blind using electrical stimulation of the visual pathways is feasible but demands an understanding of the spatial mapping of the visual world at the site of targeted stimulation, whether in the retina, thalamus, or cortex. While a visual cortex stimulator can bypass the eye and create visual percepts, there is an inherent dissociation between this stimulation and eye movements. It is unknown whether and how robustly the brain maintains the oculomotor circuitry in patients with bare- or no-light perception. Objective: To critically and quantitatively evaluate the effect of eye movements have on phosphene locations elicited by cortical stimulation that bypasses the eyes in order to restore sight in blind subjects. Methods: The NeuroPace Responsive Neurostimulator (RNS) and the Orion visual cortical prosthesis devices were used to electrically stimulate the visual cortex of blind subjects with bare or no light perception. Eye positions were recorded synchronized with stimulation and the location of the percepts were measured using a handheld marker. Results: The locations of cortical stimulation-evoked percepts are shifted based on the eye position at the time of stimulation. Measured responses can be remapped based on measured eye positions to determine the retinotopic locations associated with the implanted electrodes, with remapped responses having variance limited by pointing error. Conclusions: Eye movements dominate the perceived location of cortical stimulation-evoked phosphenes, even after years of blindness. By accounting for eye positions, we can mimic retinal mapping as in natural sight.

Globally, it is estimated there are more than 2.2 billion visually impaired people. Visual diseases such as retinitis pigmentosa, age-related macular degeneration, glaucoma, and optic neuritis can cause irreversible profound vision loss. Many groups have investigated different approaches such as microelectronic prostheses, optogenetics, stem cell therapy, and gene therapy to restore vision. However, these methods have some limitations such as invasive implantation surgery and unknown long-term risk of genetic manipulation. In addition to the safety of ultrasound as a medical imaging modality, ultrasound stimulation can be a viable non-invasive alternative approach for the sight restoration because of its ability to non-invasively control neuronal activities. Indeed, recent studies have demonstrated ultrasound stimulation can successfully modulate retinal/brain neuronal activities without causing any damage to the nerve cells. Superior penetration depth and high spatial resolution of focused ultrasound can open a new avenue in neuromodulation researches. This review summarizes the latest research results about neural responses to ultrasound stimulation. Also, this work provides an overview of technical viewpoints in the future design of a miniaturized ultrasound transducer for a non-invasive acoustic visual prosthesis for non-surgical and painless restoration of vision. [ABSTRACT FROM AUTHOR]

Cortical visual prostheses that aim to restore sight to the blind require the ability to create neural activity in the visual cortex. Electric stimulation delivered via microelectrodes implanted in the primary visual cortex (V1) has been the most common approach, although conventional electrodes may not effectively confine activation to focal regions and thus the acuity they create may be limited. Magnetic stimulation from microcoils confines activation to single cortical columns of V1 and thus may prove to be more effective than conventional microelectrodes, but the ability of microcoils to drive synaptic connections has not been explored. Here, we show that magnetic stimulation of V1 using microcoils induces spatially confined activation in the secondary visual cortex (V2) in mouse brain slices. Single-loop microcoils were fabricated using platinum–iridium flat microwires, and their effectiveness was evaluated using calcium imaging and compared with that of monopolar and bipolar electrodes. Our results show that compared to the electrodes, the microcoils better confined activation to a small region in V1. In addition, they produced more precise and sustained activation in V2. The finding that microcoil-based stimulation propagates to higher visual centres raises the possibility that complex visual perception, e.g. that requiring sustained synaptic inputs, may be achievable. This article is part of the theme issue 'Advanced neurotechnologies: translating innovation for health and well-being'. [ABSTRACT FROM AUTHOR]

Brain-Machine Interfaces (BMI) offer the potential to modulate dysfunctional neurological networks by electrically stimulating the cerebral cortex via chronically-implanted microelectrodes. Wireless transmitters worn by BMI recipients must operate within electromagnetic emission and tissue heating limits, such as those prescribed by the IEEE and International Commission on Non-Ionizing Radiation Protection (ICNIRP), to ensure that radiofrequency emissions of BMI systems are safe. Here, we describe an approach to generating pre-compliance safety data by simulating the Specific Absorption Rate (SAR) and tissue heating of a multi-layered human head model containing a system of wireless, modular BMIs powered and controlled by an externally worn telemetry unit. We explore a number of system configurations such that our approach can be utilized for similar BMI systems, and our results provide a benchmark for the electromagnetic emissions of similar telemetry units. Our results show that the volume-averaged SAR per 10g of tissue exposed to our telemetry field complies with ICNIRP and IEEE reference levels, and that the maximum temperature increase in tissues was within permissible limits. These results were unaffected by the number of implants in the system model, and therefore we conclude that the electromagnetic emissions our BMI in any configuration are safe. [ABSTRACT FROM AUTHOR]

Globally, it is estimated there are more than 2.2 billion visually impaired people. Visual diseases such as retinitis pigmentosa, age-related macular degeneration, glaucoma, and optic neuritis can cause irreversible profound vision loss. Many groups have investigated different approaches such as microelectronic prostheses, optogenetics, stem cell therapy, and gene therapy to restore vision. However, these methods have some limitations such as invasive implantation surgery and unknown long-term risk of genetic manipulation. In addition to the safety of ultrasound as a medical imaging modality, ultrasound stimulation can be a viable non-invasive alternative approach for the sight restoration because of its ability to non-invasively control neuronal activities. Indeed, recent studies have demonstrated ultrasound stimulation can successfully modulate retinal/brain neuronal activities without causing any damage to the nerve cells. Superior penetration depth and high spatial resolution of focused ultrasound can open a new avenue in neuromodulation researches. This review summarizes the latest research results about neural responses to ultrasound stimulation. Also, this work provides an overview of technical viewpoints in the future design of a miniaturized ultrasound transducer for a non-invasive acoustic visual prosthesis for non-surgical and painless restoration of vision.

BackgroundThe main objective of this study was to test Argus II subjects on three real-world functional vision tasks.DesignThe study was designed to be randomized and prospective. Testing was conducted in a hospital/research laboratory setting at the various participating centres.ParticipantsTwenty eight Argus II subjects, all profoundly blind, participated in this study.MethodsSubjects were tested on the three real-world functional vision tasks: Sock Sorting, Sidewalk Tracking and Walking Direction Discrimination task MAIN OUTCOME MEASURES: For the Sock Sorting task, percentage correct was computed based on how accurately subjects sorted the piles on a cloth-covered table and on a bare table. In the Sidewalk Tracking task, an 'out of bounds' count was recorded, signifying how often the subject veered away from the test course. During the Walking Direction Discrimination task, subjects were tested on the number of times they correctly identified the direction of testers walking across their field of view.ResultsThe mean percentage correct OFF versus ON for the Sock Sorting task was found to be significantly different for both testing conditions (t-test, P

BackgroundThe purpose of this analysis is to report the change in quality of life (QoL) after treatment with the Argus II Epiretinal Prosthesis in patients with end-stage retinitis pigmentosa.MethodsThe Vision and Quality of Life Index (VisQoL) was used to assess changes in QoL dimensions and overall utility score in a prospective 30-patient single-arm clinical study. VisQoL is a multi-attribute instrument consisting of six dimensions (injury, life, roles, assistance, activity and friendship) that may be affected by visual impairment. Within each dimension, patients were divided into two groups based on how much their QoL was affected by their blindness at baseline (moderate/severe or minimal). Outcomes were compared within each dimension sub-group between baseline and the combined follow-up periods using the Friedman test. In addition, data from the six dimensions were combined into a single utility score, with baseline data compared to the combined follow-up periods.ResultsOverall, 80 per cent of the patients reported difficulty in one or more dimensions pre-implant. Composite VisQoL utility scores at follow-up showed no statistically significant change from baseline; however, in three of the six VisQoL dimensions (injury, life and roles), patients with baseline deficits showed significant and lasting improvement after implantation with Argus II. In two of the three remaining dimensions (assistance and activity), data trended toward an improvement. In the final VisQoL dimension (friendship), none of the patients reported baseline deficits, suggesting that patients had largely adjusted to this attribute.ConclusionPatients whose vision negatively affected them with respect to three VisQoL dimensions (that is, getting injured, coping with the demands of their life and fulfilling their life roles) reported significant improvement in QoL after implantation of the Argus II retinal prosthesis. Furthermore, the benefit did not deteriorate at any point during the 36-month follow-up, suggesting a long-term, durable improvement.

PurposeThe Argus II Retinal Prosthesis System (Second Sight Medical Products, Inc, Sylmar, CA) was developed to restore some vision to patients blind as a result of retinitis pigmentosa (RP) or outer retinal degeneration. A clinical trial was initiated in 2006 to study the long-term safety and efficacy of the Argus II System in patients with bare or no light perception resulting from end-stage RP.DesignProspective, multicenter, single-arm clinical trial. Within-patient controls included the nonimplanted fellow eye and patients' native residual vision compared with their vision with the Argus II.ParticipantsThirty participants in 10 centers in the United States and Europe.MethodsThe worse-seeing eye of blind patients was implanted with the Argus II. Patients wore glasses mounted with a small camera and a video processor that converted images into stimulation patterns sent to the electrode array on the retina.Main outcome measuresThe primary outcome measures were safety (the number, seriousness, and relatedness of adverse events) and visual function, as measured by 3 computer-based, objective tests. Secondary measures included functional vision performance on objectively scored real-world tasks.ResultsTwenty-four of 30 patients remained implanted with functioning Argus II Systems at 5 years after implantation. Only 1 additional serious adverse event was experienced after the 3-year time point. Patients performed significantly better with the Argus II on than off on all visual function tests and functional vision tasks.ConclusionsThe 5-year results of the Argus II trial support the long-term safety profile and benefit of the Argus II System for patients blind as a result of RP. The Argus II is the first and only retinal implant to have market approval in the European Economic Area, the United States, and Canada.

ObjectiveThe purpose of this analysis was to compare observer-rated tasks in patients implanted with the Argus II Retinal Prosthesis System, when the device is ON versus OFF.MethodsThe Functional Low-Vision Observer Rated Assessment (FLORA) instrument was administered to 26 blind patients implanted with the Argus II Retinal Prosthesis System at a mean follow-up of 36 months. FLORA is a multi-component instrument that consists in part of observer-rated assessment of 35 tasks completed with the device ON versus OFF. The ease with which a patient completes a task is scored using a four-point scale, ranging from easy (score of 1) to impossible (score of 4). The tasks are evaluated individually and organised into four discrete domains, including 'Visual orientation', 'Visual mobility', 'Daily life and 'Interaction with others'.ResultsTwenty-six patients completed each of the 35 tasks. Overall, 24 out of 35 tasks (69 per cent) were statistically significantly easier to achieve with the device ON versus OFF. In each of the four domains, patients' performances were significantly better (p < 0.05) with the device ON versus OFF, ranging from 19 to 38 per cent improvement.ConclusionPatients with an Argus II Retinal Prosthesis implanted for 18 to 44 months (mean 36 months), demonstrated significantly improved completion of vision-related tasks with the device ON versus OFF.

Given the rising number of patients with blindness from macular, optic nerve, and visual pathway disease, there is considerable interest in the potential of electrical stimulation devices to restore vision. Electrical devices for restoration of visual function can be grouped into three categories: (1) visual prostheses whose goal is to bypass damaged areas and directly activate downstream intact portions of the visual pathway; (2) electric field stimulation whose goal is to activate endogenous transcriptional and molecular signaling pathways to promote neuroprotection and neuro-regeneration; and (3) neuromodulation whose stimulation would resuscitate neural circuits vital to coordinating responses to visual input. In this review, we discuss these three approaches, describe advances made in the different fields, and comment on limitations and potential future directions. [ABSTRACT FROM AUTHOR]

Neural implants have the potential to restore visual capabilities in blind individuals by electrically stimulating the neurons of the visual system. This stimulation can produce visual percepts known as phosphenes. The ideal location of electrical stimulation for achieving vision restoration is widely debated and dependent on the physiological properties of the targeted tissue. Here, the neurophysiology of several potential target structures within the visual system will be explored regarding their benefits and downfalls in producing phosphenes. These regions will include the lateral geniculate nucleus, primary visual cortex, visual area 2, visual area 3, visual area 4 and the middle temporal area. Based on the existing engineering limitations of neural prostheses, we anticipate that electrical stimulation of any singular brain region will be incapable of achieving high-resolution naturalistic perception including color, texture, shape and motion. As improvements in visual acuity facilitate improvements in quality of life, emulating naturalistic vision should be one of the ultimate goals of visual prostheses. To achieve this goal, we propose that multiple brain areas will need to be targeted in unison enabling different aspects of vision to be recreated. [ABSTRACT FROM AUTHOR]

Clinical results with photovoltaic subretinal prosthesis (PRIMA) demonstrated restoration of sight via electrical stimulation of the interneurons in degenerated retina, with resolution matching the 100 μm pixel size. Since scaling the pixels below 75 μm in the current bipolar planar geometry will significantly limit the penetration depth of the electric field and increase stimulation threshold, we explore the possibility of using smaller pixels based on a novel 3-dimensional honeycomb-shaped design. We assessed the long-term biocompatibility and stability of these arrays in rats by investigating the anatomical integration of the retina with flat and 3D implants and response to electrical stimulation over lifetime - up to 32-36 weeks post-implantation in aged rats. With both flat and 3D implants, signals elicited in the visual cortex decreased after the day of implantation by more than 3-fold, and gradually recovered over the next 12-16 weeks. With 25 μm high honeycomb walls, the majority of bipolar cells migrate into the wells, while amacrine and ganglion cells remain above the cavities, which is essential for selective network-mediated stimulation of the retina. Retinal thickness and full-field stimulation threshold with 40 μm-wide honeycomb pixels were comparable to those with planar devices - 0.05 mW/mm 2 with 10 ms pulses. However, fewer cells from the inner nuclear layer migrated into the 20 μm-wide wells, and stimulation threshold increased over 12-16 weeks, before stabilizing at about 0.08 mW/mm 2 . Such threshold is still significantly lower than 1.8 mW/mm 2 with a previous design of flat bipolar pixels, confirming the promise of the 3D honeycomb-based approach to high resolution subretinal prosthesis., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Daniel Palanker reports financial support was provided by National Institutes of Health. Daniel Palanker reports financial support was provided by U.S. Department of Defense. Daniel Palanker reports financial support was provided by Air Force Office of Scientific Research. Daniel Palanker reports a relationship with Pixium Vision that includes: consulting or advisory. Ted Kamins reports a relationship with Pixium Vision that includes: consulting or advisory. Daniel Palanker has patent licensed to Pixium Vision. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Ultrasound (US) can easily penetrate media with excellent spatial precision corresponding to its wavelength. Naturally, US plays a pivotal role in the echolocation abilities of certain mammals such as bats and dolphins. In addition, medical US generated by transducers interact with tissues via delivering ultrasonic energy in the modes of heat generation, exertion of acoustic radiation force (ARF), and acoustic cavitation. Based on the principle of echolocation, various assistive devices for visual impairment people have been developed. High-Intensity Focused Ultrasound (HIFU) are developed for targeted ablation and tissue destruction. Besides thermal ablation, histotripsy with US is designed to damage tissue purely via mechanical effect without thermal coagulation. Low-Intensity Focused Ultrasound (LIFU) has been proven to be an effective stimulation method for neuromodulation. Furthermore, US has been reported to transiently increase the permeability of biological membranes, enabling acoustic transfection and blood-brain barrier open. All of these advances in US are changing the clinic. This review mainly introduces the advances in these aspects, focusing on the physical and biological principles, challenges, and future direction., (© 2024 Wiley‐VCH GmbH.)

Objective. Visual prostheses are effective tools for restoring vision, yet real-world complexities pose ongoing challenges. The progress in AI has led to the emergence of the concept of intelligent visual prosthetics with auditory support, leveraging deep learning to create practical artificial vision perception beyond merely restoring natural sight for the blind. Approach. This study introduces an object-based attention mechanism that simulates human gaze points when observing the external world to descriptions of physical regions. By transforming this mechanism into a ranking problem of salient entity regions, we introduce prior visual attention cues to build a new salient object ranking (SaOR) dataset, and propose a SaOR network aimed at providing depth perception for prosthetic vision. Furthermore, we propose a SaOR-guided image description method to align with human observation patterns, toward providing additional visual information by auditory feedback. Finally, the integration of the two aforementioned algorithms constitutes an audiovisual cognitive optimization strategy for prosthetic vision. Main results. Through conducting psychophysical experiments based on scene description tasks under simulated prosthetic vision, we verify that the SaOR method improves the subjects' performance in terms of object identification and understanding the correlation among objects. Additionally, the cognitive optimization strategy incorporating image description further enhances their prosthetic visual cognition. Significance. This offers valuable technical insights for designing next-generation intelligent visual prostheses and establishes a theoretical groundwork for developing their visual information processing strategies. Code will be made publicly available., (© 2024 IOP Publishing Ltd. All rights, including for text and data mining, AI training, and similar technologies, are reserved.)

Neural implants have the potential to restore lost sensory function by electrically evoking the complex naturalistic activity patterns of neural populations. However, it can be difficult to predict and control evoked neural responses to simultaneous multi-electrode stimulation due to nonlinearity of the responses. We present a solution to this problem and demonstrate its utility in the context of a bidirectional retinal implant for restoring vision. A dynamically optimized stimulation approach encodes incoming visual stimuli into a rapid, greedily chosen, temporally dithered and spatially multiplexed sequence of simple stimulation patterns. Stimuli are selected to optimize the reconstruction of the visual stimulus from the evoked responses. Temporal dithering exploits the slow time scales of downstream neural processing, and spatial multiplexing exploits the independence of responses generated by distant electrodes. The approach was evaluated using an experimental laboratory prototype of a retinal implant: large-scale, high-resolution multi-electrode stimulation and recording of macaque and rat retinal ganglion cells ex vivo. The dynamically optimized stimulation approach substantially enhanced performance compared to existing approaches based on static mapping between visual stimulus intensity and current amplitude. The modular framework enabled parallel extensions to naturalistic viewing conditions, incorporation of perceptual similarity measures, and efficient implementation for an implantable device. A direct closed-loop test of the approach supported its potential use in vision restoration., Competing Interests: NS, AP, SM, AL, AG, MH, LG, JB, AD, PT, PH, WD, AS, AL, SM, EC No competing interests declared, (© 2024, Shah, Phillips et al.)

Background: Retinal prostheses offer hope for individuals with degenerative retinal diseases by stimulating the remaining retinal cells to partially restore their vision. This review delves into the current advancements in retinal prosthesis technology, with a special emphasis on the pivotal role that image processing and machine learning techniques play in this evolution., Methods: We provide a comprehensive analysis of the existing implantable devices and optogenetic strategies, delineating their advantages, limitations, and challenges in addressing complex visual tasks. The review extends to various image processing algorithms and deep learning architectures that have been implemented to enhance the functionality of retinal prosthetic devices. We also illustrate the testing results by demonstrating the clinical trials or using Simulated Prosthetic Vision (SPV) through phosphene simulations, which is a critical aspect of simulating visual perception for retinal prosthesis users., Results: Our review highlights the significant progress in retinal prosthesis technology, particularly its capacity to augment visual perception among the visually impaired. It discusses the integration between image processing and deep learning, illustrating their impact on individual interactions and navigations within the environment through applying clinical trials and also illustrating the limitations of some techniques to be used with current devices, as some approaches only use simulation even on sighted-normal individuals or rely on qualitative analysis, where some consider realistic perception models and others do not., Conclusion: This interdisciplinary field holds promise for the future of retinal prostheses, with the potential to significantly enhance the quality of life for individuals with retinal prostheses. Future research directions should pivot towards optimizing phosphene simulations for SPV approaches, considering the distorted and confusing nature of phosphene perception, thereby enriching the visual perception provided by these prosthetic devices. This endeavor will not only improve navigational independence but also facilitate a more immersive interaction with the environment., (© 2024 International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC.)

The past 20 years have witnessed significant advancements in the field of visual prostheses, with developments spanning from early retinal implants to recent cortical approaches. This Perspective looks at some of the remaining challenges to achieve the ambitious clinical goals that these technologies could enable., Competing Interests: The authors have declared no competing interest exist., (Copyright: © 2024 Fernandez, Robles. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Neuroelectronic prostheses are being developed for restoring vision at the retinal level in patients who have lost their sight due to photoreceptor loss. The core component of these devices is the electrode array, which enables interfacing with retinal neurons. Generating the perception of meaningful images requires high-density microelectrode arrays (MEAs) capable of precisely activating targeted retinal neurons. Achieving this precision necessitates the downscaling of electrodes to micrometer dimensions. However, miniaturization increases electrode impedance, which poses challenges by limiting the amount of current that can be delivered, thereby impairing the electrode's capability for effective neural modulation. Additionally, it elevates noise levels, reducing the signal quality of the recorded neural activity. This report focuses on evaluating reduced graphene oxide (rGO) based devices for interfacing with the retina, showcasing their potential in vision restoration. Our findings reveal low impedance and high charge injection limit for microscale rGO electrodes, confirming their suitability for developing next-generation high-density retinal devices. We successfully demonstrated bidirectional interfacing with cell cultures and explanted retinal tissue, enabling the identification and modulation of multiple cells' activity. Additionally, calcium imaging allowed real-time monitoring of retinal cell dynamics, demonstrating a significant reduction in activated areas with small-sized electrodes. Overall, this study lays the groundwork for developing advanced rGO-based MEAs for high-acuity visual prostheses.