Improvements in vision‐related quality of life in blind patients implanted with the Argus II Epiretinal Prosthesis

Abstract

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.

Psychosocial assessment of potential retinal prosthesis trial participants

“…The IVI may be more sensitive to change and thus, more useful in evaluating the effectiveness of treatments and interventions. The VisQoL has previously been used in the Argus II retinal prosthesis trials, with significant improvements in half of the dimensions measured (injury, life and roles) . For these reasons, we have elected to use both the VisQoL and IVI in future selection protocols for retinal prosthesis trials.…”

The Argus-II Retinal Prosthesis Implantation; From the Global to Local Successful Experience

“…Just recently, some image-processing software modifications have been applied to improve the Argus-II vision regarding edge-detection in grating visual acuity (GVA) leading to better shape and object recognition (Duncan et al, 2017 ).…”

“…Argus II developers have started to work on the next-generation implant with 240 electrodes, which can also be improved by peripheral electrodes. Their eventual goal is to minimize the size of the electrode similar to the retinal ganglion cell bodies, with the capacity of individual cell activation (Duncan et al, 2017 ).…”

“…The Argus II system ON vs. OFF could also provide patients with significant improvement in orientation and mobility tests i.e., finding a door and following a line. These tests are referred to as a “door task” and “line task” when assessing functional vision of patients with ultra-low vision (Ghodasra et al, 2016 ; Duncan et al, 2017 ).…”

Das Usher-Syndrom, eine Ziliopathie des Menschen

“…Retinaimplantate kommen nur für vollständig erblindete Patienten infrage. Auch ermöglichen sie bislang nur die Perzeption von Konturen und Helligkeitsunterschieden, haben jedoch einen sehr positiven Effekt auf die Lebensqualität der Patienten [26].…”