Aries Arditi

Long-Term Results from an Epiretinal Prosthesis to Restore Sight to the Blind

PURPOSE Retinitis pigmentosa (RP) is a group of inherited retinal degenerations leading to blindness due to photoreceptor loss. Retinitis pigmentosa is a rare disease, affecting only approximately 100 000 people in the United States. There is no cure and no approved medical therapy to slow or reverse RP. The purpose of this clinical trial was to evaluate the safety, reliability, and benefit of the Argus II Retinal Prosthesis System (Second Sight Medical Products, Inc, Sylmar, CA) in restoring some visual function to subjects completely blind from RP. We report clinical trial results at 1 and 3 years after implantation. DESIGN The study is a multicenter, single-arm, prospective clinical trial. PARTICIPANTS There were 30 subjects in 10 centers in the United States and Europe. Subjects served as their own controls, that is, implanted eye versus fellow eye, and system on versus system off (native residual vision). METHODS The Argus II System was implanted on and in a single eye (typically the worse-seeing eye) of blind subjects. Subjects 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 MEASURES The primary outcome measures were safety (the number, seriousness, and relatedness of adverse events) and visual function, as measured by 3 computer-based, objective tests. RESULTS A total of 29 of 30 subjects had functioning Argus II Systems implants 3 years after implantation. Eleven subjects experienced a total of 23 serious device- or surgery-related adverse events. All were treated with standard ophthalmic care. As a group, subjects performed significantly better with the system on than off on all visual function tests and functional vision assessments. CONCLUSIONS The 3-year results of the Argus II trial support the long-term safety profile and benefit of the Argus II System for patients blind from RP. Earlier results from this trial were used to gain approval of the Argus II by the Food and Drug Administration and a CE mark in Europe. The Argus II System is the first and only retinal implant to have both approvals.

Serifs and font legibility

Using lower-case fonts varying only in serif size (0%, 5%, and 10% cap height), we assessed legibility using size thresholds and reading speed. Five percentage serif fonts were slightly more legible than sans serif, but the average inter-letter spacing increase that serifs themselves impose, predicts greater enhancement than we observed. RSVP and continuous reading speeds showed no effect of serifs. When text is small or distant, serifs may, then, produce a tiny legibility increase due to the concomitant increase in spacing. However, our data exhibited no difference in legibility between typefaces that differ only in the presence or absence of serifs.

Effects of chromatic and luminance contrast on reading

Reading performance was measured for drifting text defined by chromatic contrast with various amounts of luminance contrast present. With 0.12 luminance contrast added, reading performance was unaffected by the presence of chromatic contrast over a range of character sizes varying 30-fold. When luminance contrast was reduced to near the threshold for reading, chromatic contrast sustained reading rates of nearly 300 words per minute, almost as high as those found with high luminance contrasts. Low-pass filtering of chromatic text had a proportionately greater effect on small characters, as would be predicted from the lower bandwidth of chromatic visual channels. Arguments are presented suggesting that reading rates for equiluminant text are sustained by luminance transients introduced by transverse chromatic aberrations of the eye.

Toward a computer vision-based wayfinding aid for blind persons to access unfamiliar indoor environments

Independent travel is a well-known challenge for blind and visually impaired persons. In this paper, we propose a proof-of-concept computer vision-based wayfinding aid for blind people to independently access unfamiliar indoor environments. In order to find different rooms (e.g. an office, a laboratory, or a bathroom) and other building amenities (e.g. an exit or an elevator), we incorporate object detection with text recognition. First, we develop a robust and efficient algorithm to detect doors, elevators, and cabinets based on their general geometric shape, by combining edges and corners. The algorithm is general enough to handle large intra-class variations of objects with different appearances among different indoor environments, as well as small inter-class differences between different objects such as doors and door-like cabinets. Next, to distinguish intra-class objects (e.g. an office door from a bathroom door), we extract and recognize text information associated with the detected objects. For text recognition, we first extract text regions from signs with multiple colors and possibly complex backgrounds, and then apply character localization and topological analysis to filter out background interference. The extracted text is recognized using off-the-shelf optical character recognition software products. The object type, orientation, location, and text information are presented to the blind traveler as speech.

Reading with fixed and variable character pitch.

We compared the effects of fixed and variable (proportional) spacing on reading speeds and found variable pitch to yield better performance at medium and large character sizes and fixed pitch to be superior for character sizes approaching the acuity limit. The data indicate at least two crowding effects at the smallest sizes: one that interferes with individual character identification and one that interferes with word identification. A control experiment using rapid serial visual presentation suggests that it is the greater horizontal compression and consequently reduced eye-movement requirements of variable pitch that are responsible for its superiority at medium and large character sizes.

Apparent string shortening concomitant with letter crowding

In our previous studies of the crowding effect, we have observed that human observers tend to underestimate the length of a letter string (the number of letters in the string) when the letters are close to visual acuity, and the interletter spacings are small. In this study, we asked our observers to identify letters in randomly presented four-letter and five-letter strings. We found that, when a priori knowledge of the lengths of letter strings was not available, the probability of underestimating string length increased with decreasing interletter spacing. The causes of underestimation errors appeared to be the omission of an interior letter and the merging of two neighboring letters. Since our experiments were conducted in the foveal region, neither spatial uncertainty nor split attention can explain the underestimation errors. The effect of the point spread function of the eye on closely packed letter strings is discussed.

Portable Camera-Based Assistive Text and Product Label Reading From Hand-Held Objects for Blind Persons

We propose a camera-based assistive text reading framework to help blind persons read text labels and product packaging from hand-held objects in their daily lives. To isolate the object from cluttered backgrounds or other surrounding objects in the camera view, we first propose an efficient and effective motion-based method to define a region of interest (ROI) in the video by asking the user to shake the object. This method extracts moving object region by a mixture-of-Gaussians-based background subtraction method. In the extracted ROI, text localization and recognition are conducted to acquire text information. To automatically localize the text regions from the object ROI, we propose a novel text localization algorithm by learning gradient features of stroke orientations and distributions of edge pixels in an Adaboost model. Text characters in the localized text regions are then binarized and recognized by off-the-shelf optical character recognition software. The recognized text codes are output to blind users in speech. Performance of the proposed text localization algorithm is quantitatively evaluated on ICDAR-2003 and ICDAR-2011 Robust Reading Datasets. Experimental results demonstrate that our algorithm achieves the state of the arts. The proof-of-concept prototype is also evaluated on a dataset collected using ten blind persons to evaluate the effectiveness of the systems hardware. We explore user interface issues and assess robustness of the algorithm in extracting and reading text from different objects with complex backgrounds.

Letter case and text legibility in normal and low vision

It is thought by cognitive scientists and typographers alike, that lower-case text is more legible than upper-case. Yet lower-case letters are, on average, smaller in height and width than upper-case characters, which suggests an upper-case advantage. Using a single unaltered font and all upper-, all lower-, and mixed-case text, we assessed size thresholds for words and random strings, and reading speeds for text with normal and visually impaired participants. Lower-case thresholds were roughly 0.1 log unit higher than upper. Reading speeds were higher for upper- than for mixed-case text at sizes twice acuity size; at larger sizes, the upper-case advantage disappeared. Results suggest that upper-case is more legible than the other case styles, especially for visually-impaired readers, because smaller letter sizes can be used than with the other case styles, with no diminution of legibility.

Detection and identification of mirror-image letter pairs in central and peripheral vision

Reading performance is poorer in the peripheral than in the central visual field, even after size-scaling to compensate for differences in visual acuity at the different eccentricities. Since several studies have indicated that the peripheral retina is deficient with respect to spatial phase discrimination, we compared the psychometric functions for detection (D) and identification (I) of size-scaled, mirror-symmetric letters (i.e. letters differing in the phase spectra of their odd symmetric components) at three inferior field eccentricities (0, 4, and 7.5 deg) using a two-alternative, temporal, forced-choice procedure and retinal image stabilization to control retinal locus. Each subjects data were fit with Weibull functions and tested for goodness-of-fit under several hypotheses. This analysis revealed that while the psychometric functions were of constant shape across eccentricity for the respective tasks, they showed statistically significant variations in the D/I threshold ratios. However, these variations were so small that poorer reading outside the fovea is unlikely to be due to reduced letter discriminability that might occur secondary to a loss of peripheral field phase sensitivity.

Adjustable typography: an approach to enhancing low vision text accessibility

Millions of people have low vision, a disability condition caused by uncorrectable or partially correctable disorders of the eye. The primary goal of low vision rehabilitation is increasing access to printed material. This paper describes how adjustable typography, a computer graphic approach to enhancing text accessibility, can play a role in this process, by allowing visually-impaired users to customize fonts to maximize legibility according to their own visual needs. Prototype software and initial testing of the concept is described. The results show that visually-impaired users tend to produce a variety of very distinct fonts, and that the adjustment process results in greatly enhanced legibility. But this initial testing has not yet demonstrated increases in legibility over and above the legibility of highly legible standard fonts such as Times New Roman.