A. Butterwick

Tissue Damage by Pulsed Electrical Stimulation

Repeated pulsed electrical stimulation is used in a multitude of neural interfaces; damage resulting from such stimulation was studied as a function of pulse duration, electrode size, and number of pulses using a fluorescent assay on chick chorioallontoic membrane (CAM) in vivo and chick retina in vitro. Data from the chick model were verified by repeating some measurements on porcine retina in-vitro. The electrode size varied from 100 mum to 1 mm, pulse duration from 6 mus to 6 ms, and the number of pulses from 1 to 7500. The threshold current density for damage was independent of electrode size for diameters greater than 300 mum, and scaled as 1/r2 for electrodes smaller than 200 mum. Damage threshold decreased with the number of pulses, dropping by a factor of 14 on the CAM and 7 on the retina as the number of pulses increased from 1 to 50, and remained constant for a higher numbers of pulses. The damage threshold current density on large electrodes scaled with pulse duration as approximately 1/t0.5, characteristic of electroporation. The threshold current density for repeated exposure on the retina varied between 0.061 A/cm2 at 6 ms to 1.3 A/cm2 at 6 mus. The highest ratio of the damage threshold to the stimulation threshold in retinal ganglion cells occurred at pulse durations near chronaxie - around 1.3 ms.

Effect of shape and coating of a subretinal prosthesis on its integration with the retina

Retinal stimulation with high spatial resolution requires close proximity of electrodes to target cells. This study examines the effects of material coatings and 3-dimensional geometries of subretinal prostheses on their integration with the retina. A trans-scleral implantation technique was developed to place microfabricated structures in the subretinal space of RCS rats. The effect of three coatings (silicon oxide, iridium oxide and parylene) and three geometries (flat, pillars and chambers) on the retinal integration was compared using passive implants. Retinal morphology was evaluated histologically 6 weeks after implantation. For 3-dimensional implants the retinal cell phenotype was also evaluated using Computational Molecular Phenotyping. Flat implants coated with parylene and iridium oxide were generally well tolerated in the subretinal space, inducing only a mild gliotic response. However, silicon-oxide coatings induced the formation of a significant fibrotic seal around the implants. Glial proliferation was observed at the base of the pillar electrode arrays and inside the chambers. The non-traumatic penetration of pillar tips into the retina provided uniform and stable proximity to the inner nuclear layer. Retinal cells migrated into chambers with apertures larger than 10 mum. Both pillars and chambers achieved better proximity to the inner retinal cells than flat implants. However, isolation of retinal cells inside the chamber arrays is likely to affect their long-term viability. Pillars demonstrated minimal alteration of the inner retinal architecture, and thus appear to be the most promising approach for maintaining close proximity between the retinal prosthetic electrodes and target neurons.

High-Resolution Opto-Electronic Retinal Prosthesis: PhysicalLimitations and Design

Electrical stimulation of the retina can produce visual percepts in blind patients suffering from macular degeneration and retinitis pigmentosa (RP). However, current retinal implants provide very low resolution (just a few electrodes), whereas many more pixels would be required for a functional restoration of sight.

Delivery of Information and Power to the Implant, Integration of the Electrode Array with the Retina, and Safety of Chronic Stimulation

The fundamental function of a visual prosthesis is to deliver information about a patient’s surroundings to his/her neurons, usually via patterned electronic stimulation. In addition to transmitting visual information from the outside world to the implanted stimulating array, visual prostheses must also pass the electrical power necessary for such stimulation from the external world to the intraocular electrode array. The first section of this chapter reviews three common methods for achieving this data and power transfer: direct wireline connections (suitable for research studies), inductively coupled coils, and photodiode-based optical systems which utilize the natural optics of the eye.

Dynamic range of safe electrical stimulation of the retina

Electronic retinal prostheses represent a potentially effective approach for restoring some degree of sight in blind patients with retinal degeneration. However, levels of safe electrical stimulation and the underlying mechanisms of cellular damage are largely unknown. We measured the threshold of cellular damage as a function of pulse duration, electrode size, and number of pulses to determine the safe range of stimulation. Measurements were performed in-vitro on embryonic chicken retina with saline-filled glass pipettes for stimulation electrodes. Cellular damage was detected using Propidium Iodide fluorescent staining. Electrode size varied from 115μm to 1mm, pulse duration from 6μs to 6ms, and number of pulses from 1 to 7,500. The threshold current density was independent of electrode sizes exceeding 400μm. With smaller electrodes the current density was scaling reciprocal to the square of the pipette diameter, i.e. acting as a point source so that the damage threshold was determined by the total current in this regime. The damage threshold current measured with large electrodes (1mm) scaled with pulse duration as t-0.5, which is characteristic of electroporation. For repeated electrical pulsed exposure on the retina the threshold current density varied between 0.059 A/cm2 at 6ms to 1.3 A/cm2 at 6μs. The dynamic range of safe stimulation, i.e. the ratio of damage threshold to stimulation threshold was found to be duration-dependent, and varied from 10 to 100 at pulse durations varying between 10μs to 10ms. Maximal dynamic range of 100 was observed near 1ms pulse durations.

Plasma-Mediated Transfection of RPE

A major obstacle in applying gene therapy to clinical practice is the lack of efficient and safe gene delivery techniques. Viral delivery has encountered a number of serious problems including immunological reactions and malignancy. Non-viral delivery methods (liposomes, sonoporation and electroporation) have either low efficiency in-vivo or produce severe collateral damage to ocular tissues. We discovered that tensile stress greatly increases the susceptibility of cellular membranes to electroporation. For synchronous application of electric field and mechanical stress, both are generated by the electric discharge itself. A pressure wave is produced by rapid vaporization of the medium. To prevent termination of electric current by the vapor cavity it is ionized thus restoring its electric conductivity. For in-vivo experiments with rabbits a plasmid DNA was injected into the subretinal space, and RPE was treated trans-sclerally with an array of microelectodes placed outside the eye. Application of 250-300V and 100-200 μs biphasic pulses via a microelectrode array resulted in efficient transfection of RPE without visible damage to the retina. Gene expression was quantified and monitored using bioluminescence (luciferase) and fluorescence (GFP) imaging. Transfection efficiency of RPE with this new technique exceeded that of standard electroporation by a factor 10,000. Safe and effective non-viral DNA delivery to the mammalian retina may help to materialize the enormous potential of the ocular gene therapy. Future experiments will focus on continued characterization of the safety and efficacy of this method and evaluation of long-term transgene expression in the presence of phiC31 integrase.