Depth Perception Next Step for Artificial Vision

Second Sight Medical Products Inc. this month secured a $2.4 million grant from the National Institutes of Health to help the company improve the depth perception on its next generation vision prosthetic, called the Orion system. Orion utilizes an implant connected to the visual cortex in the brain and a camera mounted on a pair of eyeglasses to provide limited sight to blind patients.  Patrick Ryan, chief operating officer at the Sylmar medical device company, said the federal grant confirmed that the company’s work is well received by the scientific community. “They share our optimism in our ability to advance this technology to help people with profound blindness,” Ryan said in an interview with the Business Journal. Johns Hopkins University, in Baltimore, will get the bulk of the money that is part of the four-year grant because the school has expertise in spatial localization and mapping, or SLAM, technology. The most well-known use of SLAM is in the sensors placed on autonomous vehicles, Ryan said. “The challenge we are faced with is taking those same sensors and fitting them into an external device that can be worn by a blind person and hopefully into one of our existing set of glasses,” Ryan said. Carnegie Mellon University’s part in the project is the contribution of Roberta Klatzky, a psychologist who has worked with the blind and studied the impact of human neurophysiology and psychology on the design of instruments and devices that can be used as navigational aids for the visually impaired. As sighted people walk through the world, they keep track of where objects can be found, how far away they are from the flow of objects across the field of vision, stereo depth perception and other visual cues, Klatzky said. Blind people, on the other hand, must acquire this information through other means, such as keeping track of how far they have walked or touching the near environment. However the representation of nearby space is formed, it must be updated as a person moves, she added. “Ideally, this updating occurs with little effortful thought,” Klatzky said in a statement. “But without such an understanding of where things lie in the environment, navigating through it requires continuous vigilance and mental work.” The challenge for Second Sight lies in getting the sensors to be small enough to fit on the glasses of the Orion visual device. Technological advances, however, are making that possible as objects are able to be made smaller and more portable. Second Sight is looking to include some additional sensors into the Orion glasses, such as infrared and lidar, which is like a radar but uses beams of light to sense where objects are, Ryan said. “It is the age-old process of compressing these things and miniaturizing them in a way that we can fit them onto the glasses,” he added. Flashes of light In the Orion system, a camera is mounted onto the bridge of the glasses that are worn by the patient. The camera acts as the patient’s eyes and takes in light flashes that get sent to a computer worn on the belt or on a lanyard around their neck. There the light flashes are changed into a series of digital signals that pass through a proprietary algorithm that is then sent to an array with 60 electrodes implanted in the patient’s visual cortex. “The light flashes are the vision that we provide and is interpreted as edges and objects and shapes that they can now use to negotiate as they go about their day,” Ryan explained. The Orion is currently an experimental investigational device. There are five human subjects who were implanted with the system more than a year ago and one subject implanted less than a year ago. The five men and one woman patients are overseen by doctors at UCLA and Baylor College of Medicine in Houston. “We are focusing on a future where Orion will be our sole commercial product,” Ryan added. As with all early feasibility studies with medical implants, the goal of the tests with Orion is to demonstrate that the device is safe. The company needs to make sure that the implants in the brain do not make medical conditions worse. After all, Ryan said, the human body is a notoriously hostile place for foreign objects that get placed inside of it. “We monitor these patients very closely with their physician groups at Baylor and UCLA to make sure this technology to help them doesn’t hurt them at all,” he added. In an Aug. 6 conference call to discuss second quarter earnings, Second Sight Chief Executive Will McGuire discussed the tests of the first five Orion patients and said all had received benefits. He highlighted one patient, who have been profiled in the Daily Mail newspaper in London, who was able to see his wife and three daughters for the first time after using Orion. “Stories like this truly motivate the team at Second Sight and provide a reminder of the impact we can have on people’s lives,” McGuire said during the call. Single product Second Sight was founded in 1998 by the late serial entrepreneur Alfred Mann and four partners, including one who suffered from retinitis pigmentosa, a cause of blindness the company addressed with its Argus prosthetic. Clinical trials of the Argus I began in 2002 with six subjects. That experience led to the development of the Argus II, which received regulatory approval in Europe in 2011 and in the U.S. from the FDA in 2013 and marked the first commercial implants for the blind in this country. Within three years, there had been 100 implants worldwide of the Argus II. The Argus works by stimulating the retina and the optic nerve. People wearing the Argus II glasses can detect the edges of a sidewalk and identify objects on a table or in front of them as they are walking, Ryan said. In the second quarter, the average selling price for an Argus II system was $128,000, according to John Blake, Second Sight’s chief financial officer. “What we are providing them is a significant improvement over what they have with residual vision,” Ryan said. “If they have no residual vision, it is a tremendous step forward for them.” The Orion, on the other hand, works by bypassing the retina and optic nerve and stimulating the visual cortex of the brain. “That is where we become the leaders in neuromodulation for vision,” Ryan said. “That is an important distinction for us.” Second Sight plans on phasing out the Argus II by the end of the year. The company will continue to provide service to the patients using the system as long as the product is viable, including glasses and cables that attach to the mini-computer, Ryan said. “Anything that needs replacement we will continue to support those patients for as long as they need it,” he added. The decision to exit the Argus II market was based on the larger population of people effected by blindness caused by conditions other than retinitis pigmentosa. “We will significantly grow our opportunity and the patients who previously would have received an Argus device will also benefit from the Orion device,” Ryan said.