Physician’s Brief clinical and research highlights for our colleagues in ophthalmology Ye a r- E n d 2014
The Bionic Eye Kellogg performs first four retinal prosthesis implants in U.S. since FDA approval In January and February 2014, Kellogg retina surgeons performed the first – and the second, third and fourth– procedure in the U.S. to implant an artificial retina, or “bionic eye,” since the U.S. Food and Drug Administration approved the device in 2013. All four patients, who range in age from 55 to 79, suffer from the degenerative and blinding eye disease retinitis pigmentosa. The device is the Argus® II Retinal Prosthesis System, developed by Second Sight Medical Products, Inc., of Sylmar, CA. The U-M Kellogg Eye Center is one of 12 major centers in the U.S. to offer the retinal prosthesis. The system is surgically implanted in one eye. The patient wears glasses equipped with a camera that captures images and converts them into a series of small electrical pulses. The pulses are transmitted wirelessly to the prosthesis and its
array of electrodes on the surface of the retina. These pulses are intended to stimulate the retina’s remaining cells, resulting in the corresponding perception of patterns of light in the brain. The technology allows individuals to see shapes and forms to help them navigate in their homes and identify the outlines of friends and family members. They will not see details of a face, but they can perceive flashes of light that help them track a person’s movements or see the outline of doorways and sidewalks. For patients who have been blind for many years, the device is close to a miracle. The retinal prosthesis is not activated until the patient has sufficiently recovered from surgery. The patient then undergoes training to learn to interpret the visual patterns in order to regain some visual function, a process that can take from one to three months. Continued on page 2
The Argus® II retina implant
Glasses, camera, antenna and video processing unit
The Eyes Have It
Continued from page 1 In an earlier clinical study of the Argus® II, most participants were able to perform basic activities better with the prosthesis than without it. Many were able to locate lights and windows, follow lines in a crosswalk, or avoid running into things as they walked. Some could sort laundry or determine where other people were located in a room, and about half were able to read very large letters (about nine inches high). In June 2014, CNN correspondent and U-M Medical School alumni Sanjay Gupta, M.D., profiled the second patient to receive the implant. Thanks to the implant and the intensive retraining that followed, the patient has begun relearning how to interpret the images he sees, such as when people step in front of him or when his young grandson runs through the room.
New ophthalmology app
The electrode array as it is positioned on the retina
Kellogg surgeons have performed four of the ten Argus® II implant procedures to date in the U.S., and two more are scheduled here in the near future.
To learn more about patient eligibility requirements for the Argus II, visit www.kellogg. umich.edu/argusii, contact the Kellogg Retinal Dystrophy Clinic at 734-763-2280 or email retina-implant@umich.edu.
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A mobile app is now available to help check symptoms, causes and common treatments for some 135 eye diseases and disorders. More than 400 photos and videos illustrate the entries, including sections on eye anatomy and eye screening basics. The app is an outgrowth of The Eyes Have It, a website created by Jonathan D. Trobe, M.D., professor and neuroophthalmologist at the U-M Kellogg Eye Center. “The program was originally intended for medical students and ophthalmology residents,” says Trobe. “But we soon discovered that pediatricians, internists and many other physicians found it to be a great resource when seeing patients with vision problems. Now the app will make it even easier for them to use.”
The app costs $4.99 and is available for iPhone and iPad on iTunes. You can also use the website at www.kellogg.umich. edu/theeyeshaveit.
For Graves’ Patients, a Destination for Compassion and Innovation Graves’ eye disease, also called thyroid eye disease or TED, is an exceptionally uncomfortable and disfiguring condition that can also be debilitating for many patients. The U-M Kellogg Eye Center is an international destination center for the multidisciplinary treatment of TED and related autoimmune disorders, and for groundbreaking research to advance our understanding of the development and treatment of these diseases. Because TED strikes each individual differently, patients treated at Kellogg benefit from personalized care planning and coordinated care with U-M specialists in other related disciplines. Our team of specialists includes orbital surgeons, strabismus surgeons, orthoptists and neuro-ophthalmologists, all experienced in the unique needs of TED patients. Working with each patient to understand his or her goals for rehabilitation, we develop a coordinated treatment plan for each patient.
Pioneering minimallyinvasive surgical options Some of the most significant advances in care available at Kellogg are minimally invasive surgical options, including procedures performed by Raymond Douglas, M.D., Ph.D. A specialist in Graves’ eye disease and a renowned orbital, facial plastic
and reconstructive surgeon, Dr. Douglas has modified standard surgical practice for reconstruction in TED, resulting in today’s patients requiring far fewer and less invasive surgeries, faster recovery and improved appearance and function. Fellow oculoplastic surgeon Alon Kahana, M.D., Ph.D., has introduced a new “stereotactic” 3-D navigation system to the Eye Center that allows surgeons to perform orbital decompression surgery with smaller incisions for a faster and safer result. “Given the proximity of the eye, brain and other vital structures, it appears that stereotactic deep orbital surgery could become the new standard of care,” says Kahana.
TED Care funds surgery, support In November 2014 a generous and grateful TED patient made an anonymous $1.5 million gift establishing a fund to help fellow sufferers face the physical, emotional and financial challenges of the disease. The fund, called TED Care, provides financial support to offset expenses for surgery or travel to the Kellogg Eye Center. “In making this exceptional gift,” notes Dr. Douglas, “our donor expressed his gratitude for our care and attention to his needs. He wants to be sure that every patient experiences the same individualized care.”
RV 001: an investigational drug trial for TED Patients diagnosed with TED may be eligible to participate in a study on the safety and effectiveness of an investigational drug called RV 001. The study lasts approximately 18 months and includes up to 19 clinic visits. To find out more, visit http://www. kellogg.umich.edu/research/open_ clinicaltrials.html.
To refer a patient, contact the Thyroid Eye Disease Clinic at 734-763-5106 or call M-LINE at 800-962-3555. To learn more about TED Care, call 734-615-1472 or email UMThyroidEyeDisease@med. umich.edu.
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