New development in the race to bring bionic eye closer to patients

A French company called Pixium Vision is testing a system called Iris that promises to improve the vision of the blind.

More than half a century ago, when he was just 18 years old, Georges (not the real name) learned that he had retinitis pigmentosa. He was told that his vision would progressively deteriorate until he was blind. As predicted, when Georges reached his early fifties, his world went completely dark. Last year, at the push of a button, Georges suddenly saw light again.

Electrode array placed on the retinal surface

 

Iris is currently undergoing a pilot testing program. The company’s founder, Bernard Gilly, is a scientist-turned-entrepreneur with a network of businesses focused on using technologies to improve human health, mostly around the nervous system.

Technological advances such as microbiology and microelectronics are creating new opportunities to restore sight and scientists are making enormous strides in understanding the workings of the brain. It’s long been known that electricity can stimulate the nervous system, and a technique called “neuromodulation” is being used to address everything from Parkinson’s disease to chronic pain. Now, it can treat blindness, too.

Iris consists of three different parts: one, the retinal implant implanted in the patient’s eye. It
comprises an electrode array affixed surgically to the surface of the retina (epi-retinal position). This electrode is connected to an electronic circuit (ASIC) containing a radio antenna for controlling the transmission of final information to each of the electrodes and for receiving power, which is transmitted by RF induction; two, the visual interface takes the form of a pair of glasses that have an integrated mini-camera with a biomimetic sensor (ATIS) and an infra-red transmitter, and three, a pocket computer connected to the visual interface by a cable. This computer replaces the signal processing function of the retina through a high-speed processor and proprietary customizable software. The image is captured by the biomimetic camera and sent to the computer
where it is analyzed and converted into a digital signal. This digital signal is then transmitted to the IR emitter integrated in the glasses, which transfers the information to an IR receiver located on the implant. The signal is then sent to the ASIC, which distributes different stimulation signals to each of the electrodes.

Epiretinal implant (c) Pixium Vision

An IRIS implant with an array of approximately 50 electrodes is currently being tested in a clinical study; and IRIS-150 with a 150-electrode array is expected to be commercialized in Europe this year.
The best candidates for Iris are patients with degenerative eye conditions. A surgeon implants a tiny silicon chip with 150 electrodes on the retina. Afterwards, the patient wears a pair of dark glasses with an integrated video camera that sends images to a portable mini-computer. This computer transforms the pictures into digital signals, which are sent back to the glasses, then transmitted wirelessly to a receiver on the implant. Pulses activate the electrodes, and the optic nerve carries the images to the brain.

After surgery, patients follow a program of rehabilitation to teach their brains how to interpret these new images. What they see is basic shapes in variations of black, white, and gray. (The resolution is still too low for them to distinguish facial features or read.)

Dr Yannick Le Mer, the surgeon who implanted the system in three of Pixium’s test subjects, says it is impossible to know beforehand how anyone will react, since it depends on each brain’s adaptability—like learning to play the piano or speak Japanese. Some catch on immediately, while others struggle.

One recent autumn day, Georges, a small, soft-spoken man, traveled from his home in Brittany to the Quinze-Vingts hospital in eastern Paris. A young therapist named Alexandre Leseigneur was waiting for him, and the two spent the day together practicing using the system in the corridors. (The glasses were not yet available for practice at home.)

Georges put the glasses on and hung a strap with the computer over his shoulder. The first time they went into the hallway, he moved hesitantly, shuffling sideways and reaching out his hand. The flashes appeared to be too bright and George felt lost. Leseigneur plugged the glasses into a laptop computer, adjusted the settings, and they went out again. This time was better. Following a black band on the floor, Georges walked the length of a corridor and even managed to avoid an obstacle blocking his path.

Gilly estimates that when the Iris arrives on the European market in late 2015, the cost to each patient will be around 100,000 euros, plus surgery. Though that might sound expensive, he says it’s a bargain compared to the price of blindness. A study at the University of Chicago forecasts that in the United States alone, costs related to eye disease and vision problems will reach $717 billion by 2050.

Last June, Pixium made an initial public offering, raising nearly 40 million euros (more than $53 million) from European investors. It is not the only company working in this field. Various permutations of what is commonly called a “bionic eye” are being developed from Germany to Australia. The pioneer is an American company, Second Sight Medical, which earned European approval for its Argus II system in 2011 and FDA approval in 2013. In November, Second Sight had its own successful IPO, raising some $32 million.

While the Iris is very similar to the Argus II, Gilly mentions a few key differences. Iris's camera captures only the changes in the environment, so that the overall view is continuous, closer to the way the human eye actually sees. The implant can also be easily removed and replaced with upgrades as they become available.

The company’s next generation product, Prima, will start clinical trials in 2016. With at least 10 times as many electrodes, it should enable people to read and to see facial features.

Prima is a miniaturized retinal prostheses (PRIMA) based on sub-retinal implant technology that is being developed in partnership with Stanford University. The PRIMA system is designed to enable greater physiological signal processing, while simplifying the surgical procedure. It will include a sub-retinal implant composed of a micro-sized wireless electrode array, featuring over 150 pixels each made of a micro-photovoltaic diode feeding a central stimulatory electrode. These arrays are fully autonomous (no wires) enabling the possibility of implanting multiple tiles in the sub-retinal space to achieve direct stimulation at the photoreceptor layer from a matrix of up to several 1,000 electrodes; the visual interface similar to that used for IRIS, consisting of a pair of glasses and an integrated biomimetic
mini-camera sensor (ATIS), and also includes a digital micromirror device to convey the visual information signal and light (power) to the micro-photovoltaic diodes, and a pocket computer is connected to the visual interface and will process the visual information into electrical signals. The Company plans to begin clinical trials of PRIMA in Europe during 2016.

Since these products lead to synthetic vision, the possibilities are vast. Soon the technology will permit users to see as clearly at night as during the day. A future device might be able to transmit the contents of an e-book or a movie directly to the retina. For now, the goal is simply to help someone locate a door in a room.

Georges agrees. He tells about how not long ago, he was taking a walk near his home, when his cane slipped under a truck. Since he didn't know it, he tried to reach out for the cane and unfortunately smacked my head against the truck. He left that if he had been using this system, he would have been able to see it.

* All pictures in this article are copyrighted of Pixium Vision

Pixium Vision & Fortune