2008 MacFarland Seminar, July 22, 2008

Training and Rehabilitation with Visual Prosthetics

 

 

2008 MacFarland Seminar, July 22, 2008
Training and Rehabilitation with Visual Prosthetics
Grand Ballroom I

 

8:30 am – 8:45 am                       Introductions by Greg Goodrich and Ron Schuchard

9:00 am –9:45 am                        First Session - Gislin Dagnelie

9:45 am – 10:30 am                     Second Session – Vernon L. Towle

10:30 am – 11:00 am                   Coffee Break

11:00 am – 11:45 am                   Third session - Duane Geruschat

11:45 am – 12:30 pm                   Fourth Session - Matt McMahon

12:30 pm – 1:45 pm                     Lunch

2:00 pm – 2:30 pm                       Fifth session - Ronald Schuchard

2:30 pm – 3:00 pm                       Q&A wrap up - Ronald Schuchard

3:00 pm – 3:15 pm                       Coffee break

3:15 pm – 4:45 pm                       Concurrent sessions

 

1. Vision Rehabilitation and Prosthetic Vision: What are is the Curriculum and Instructional Techniques: Duane Geruschat - Room: Purdue & Wisconsin
2. Retinal Implants, Oh My! What’s a Rehabber To Do? – Gislin Dagnelie – Room: Northwestern & Ohio State

                                            

The seemingly impossible goal  of restoring partial sight to the blind is moving from dream to possibility in our times.  Restoration of functional vision through the use of implanted retinal prosthetic devices that provide a neurotrophic effect to stimulate nerve growth factors in the retina in patients with photoreceptor degeneration continues to evolve.  For those who have no remaining functional vision, the day is approaching when a retinal prosthetic will provide functional vision for everyday tasks by detecting the light with a camera and stimulating the retina with an implanted chip.  Any successful implant must be biocompatible and display long-term durability.  One day, it may be possible to regenerate essential retinal elements that may eventually repair retinal damage.  It is hoped that a combination of basic science research and prosthetic device development may one day restore functional vision in patients who are  blind.

Visual prosthetics R&D programs to date have focused on overcoming the technical challenges such as:  1) biocompatibility; 2) electrical interface for signal transmission; and 3) to make a larger array of “photoreceptor pixels” while still having a prostheses that is accepted by the retina / eye. With the promise of new biotechnologies, it is important not to lose sight of the fact that these novel clinical care and research strategies must ultimately be shown to benefit the person. These strategies require, therefore, the development of validated outcomes measures that have been fully tested and designed to evaluate the essential everyday functional abilities of patients with visual impairments as well as people who have profound vision loss. These instruments should be used to acquire evidence that these new technologies and other innovative rehabilitative interventions improve activities of daily living and quality of life. Until recently, perhaps because the reality of such a device seemed to dwell more in the realm of science fiction than science facte, there has been very little consideration for determining the functional vision efficacy of a prosthesis.

There is a need to accurately and effectively measure not only the pre-implantation everyday function compared to the post-implantation everyday function but also any resultant improvement in independence and quality of life.

As part of a wider effort to discuss these issues among the various stakeholders (rehabilitation professionals, consumers, caregivers, and manufacturers/companies) the MacFarland Seminar will stimulate a dialogue among the diverse professionals providing rehabilitation for people who would be candidates for a visual prostheses or other biotechnology therapy (e.g., gene therapy or stem cell therapy).   Issues to be discussed include:

1. Does pre-blindness visual experience impact on adaptation to the prosthesis?
2. For what aspects of everyday life tasks does the implantation of a prosthesis give better function in everyday life activities than training alone?
3. What rehabilitative training contributes to optimal benefit of the prostheses?
4. When should rehabilitative training be started; before or after the retinal prosthesis implantation?
5. Should the retinal prosthesis be custom developed/made for each person based on their personal goals?

MacFarland Seminar Topics and Speakers

Overview of the current state of the art in Retinal Prosthetics
Gislin Dagnelie, Johns Hopkins University

 

Dr. Dagnelie, Ph.D., is an Associate Professor of Ophthalmology in the Johns Hopkins University School of Medicine and the associate director of the Lions Vision Research and Rehabilitation Center, a division of the Wilmer Eye Institute.  His work over the last 20 years has been supported by grants from the National Eye Institute, National Center for Complementary and Alternative Medicine, National Science Foundation, Foundation Fighting Blindness, and several companies developing ophthalmic devices and/or visual prosthetics.  In addition to his role as the Center Principal Investigator for the Optobionics (2004-2007) and Second Sight Argus 2 (2007-present) clinical trials, Dr. Dagnelie plays a leading role in the development of a Clinical Treatment and Evaluation Center at Johns Hopkins, with sponsorship of the National Neuro Research Institute, and is leading an NEI-sponsored effort to convert standard personal computers into precise tools for visual function measurement through development of an affordable calibration device.

 

Dr. Dagnelie is a native of the Netherlands, where he grew up in Rotterdam.  From his father, a lung specialist, he inherited his interest in medicine, while the talents in engineering shared by many members of his mother's family made him decide to approach medical research through the physical sciences.  He received a master's degree in experimental physics at the University of Groningen, and a Ph.D. in medical physics at the University of Amsterdam.  In 1986, Dr. Dagnelie became a postdoctoral fellow in the department of ophthalmology at Johns Hopkins, and remains a member of the research staff at that center to this day.  He is an amateur vocalist and violinist, married to Dr. Brenda Rapp, a professor of cognitive science at Johns Hopkins University, and has a 16-year old son.

 

Milestones for the Development of Cortical Visual Prosthetics

Dr. Vernon L. Towle, University of Chicago

 

Dr. Towle is a neurophysiologist and Professor of Neurology, Surgery, Pediatrics and Psychiatry at the University of Chicago.  His research and clinical work involves recording and stimulating the human visual system and other cortical regions in neurologic and neurosurgical patients.  He is collaborating with a national team headed by Phil Troyk at Illinois Institute of Technology in the development and testing of a cortical visual prosthesis.  The stimulating paradigms were first tested in primates, and are now being initiated in humans.

 

 

The Potential of Prosthetics to Improve O&M Activities
Duane Geruschat, Johns Hopkins University

Duane Geruschat Ph.D. is the Director of Research at the Maryland School for the Blind and a Research Associate in Ophthalmology at the Wilmer Eye Institute, Johns Hopkins School of Medicine.  He currently serves as the editor in chief of the Journal of Visual Impairment and Blindness.  Certified as an orientation and mobility specialist and a low vision therapist, he has 30 years of experience as a direct service provider and rehabilitation researcher.

 

The Second Sight Retinal Prosthesis: Research and Results from the Clinic
Matt McMahon, Second Sight Medical Products, Inc

 

Matthew J. McMahon, Ph.D. is Senior Principal Scientist at Second Sight Medical Products, a company founded in 1998 to create a retinal prosthesis to provide sight to patients blinded from outer retinal degenerations, such as Retinitis Pigmentosa and Macular Degeneration. He earned his B.S. in Optics at the University of Rochester in 1993 and his Ph.D. in Experimental Psychology from the University of California, San Diego in 2000. His broad background in vision science has included research in visual psychophysics, retinal imaging, and retinal physiology.

 

New Bio Technologies on the Horizon but Soon to be in Clinical Trials

Ronald Schuchard, Seminar Leader, Atlanta VA Rehabilitation R&D Center of Excellence

 

Ronald A. Schuchard is the Director of the Rehabilitation Research and Development Center of Excellence for Aging Veterans with Vision Loss.  He holds an Associate Professor appointment at the Emory University School of Medicine in the Department of Neurology with joint appointments in Ophthalmology, and Rehabilitation Medicine.  He also holds an Adjunct Associate Professor appointment in the Department of Psychology, the University of Georgia.  Dr. Schuchard earned a M.S. in Physics from DePaul University and a Ph.D. in Medical Physics from the University of Chicago. He completed a vision research fellowship at the Wilmer Institute of the Johns Hopkins University.  The application of the scanning laser ophthalmoscope (SLO) and eye tracking technology to functional vision testing and neuro-plasticity/neuro-reorganization for vision rehabilitation is the focus of his research at this time.

 

Dr. Schuchard directs the Web presence for the Low Vision Research Group and serves on many national boards including the editorial board of the Journal of Rehabilitation Research & Development and the IEEE Transactions on Neural Systems & Rehabilitation Engineering.