The goal of this study is to transfer the surgical implantation technique and evaluate the safety and effectiveness of the RETINA IMPLANT Alpha AMS to restore limited visual function and functional vision in blind Retinitis Pigmentosa (RP) patients who are at the Light Perception (LP) or No Light Perception vision level (NLP). The safety of the implantation procedure and the long-term presence of the RETINA IMPLANT Alpha AMS will be assessed with clinical exams and objective clinical tests for the absence of any new permanent damage to the structure and function of the implanted eye with no permanent injury to the health and/or well being of the implanted patient as a result of the surgical procedure or presence of the implant. The effectiveness of the RETINA IMPLANT Alpha AMS will be evaluated by measuring limited visual function and functional vision in implanted subjects with the device "ON" and "OFF" in a randomized order. The ability to restore limited vision in blind RP patients with LP vision or NLP will reduce their disability and morbidity and provide a viable option to combat their disease and improve their lives.
Retinitis Pigmentosa (RP) is a rare genetic disorder albeit the most common cause of inherited blindness. With progressive loss of function and cells in the outer retina, individuals with RP can progress to complete blindness of Light Perception or No Light Perception. There is no known cure or treatment for RP individuals at the Light Perception or No Light Perception phase of this progressive degenerative disease. The RETINA IMPLANT Alpha AMS is an investigational device designed to restore limited visual function and functional vision in this subset of patients suffering with RP whose visual acuity has deteriorated to the level of Light Perception or No Light Perception. The RETINA IMPLANT Alpha AMS has been designed to replace the non-functioning and absent photoreceptor cells with a functional device to stimulate the remaining components of the retina to restore limited visual function and functional vision in patients with RP. The RETINA IMPLANT Alpha AMS device is surgically implanted subretinally to replace the non-functioning pathologic photoreceptor/RPE layer (or absent photoreceptor cells and defective pigment epithelium). The focusing lens system of the eye directs the visual image onto the device. When turned "ON" the device then stimulates the remaining visual cells of the inner layers of the retina and this visual information is subsequently transmitted by the remaining retinal network via the optic nerve to the visual cortex in the Central Nervous System (CNS). This investigation is an Early Feasibility Study and will seek to implant five (5) to eight (8) patients. One surgical team, highly experienced in similar vitreoretinal procedures will be trained and will implant the enrolled patients. Follow-up visits for each patient will include an evaluation of safety and effectiveness at various time periods with follow-up continuing through five (5) years. The use of masking in this clinical trial will be employed at the level of implanted subjects undergoing effectiveness evaluations during the follow-up visits as further described. Implant "ON" and "OFF" modality will be randomized and unknown to each subject undergoing functional vision tests during the follow-up visit. The "ON" and "OFF" will be encoded as either mode-1 or mode-2; for each test run, mode-1 and mode-2 will be differently encoded. The subject's visual performance will be evaluated and recorded for both "ON" and "OFF" implant conditions. Each potential subject will undergo screening and evaluation to document that the eligibility criteria have been met and for proper surgical planning for implantation of the RETINA IMPLANT Alpha AMS. Qualifying subjects will undergo surgical implantation of the RETINA IMPLANT Alpha AMS in one eye and will be followed immediately in the post-operative period. Follow-up will continue for five (5) years.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Implantation of the subretinal RETINA IMPLANT Alpha AMS
Wills Eye Hospital
Philadelphia, Pennsylvania, United States
Safety - Incidence of procedure or implant related adverse events
The safety endpoint is the absence of any new permanent damage to the function and structure of the implanted eye, consisting of new neovascularization, epiretinal membrane formation, and subretinal fibrotic tissue formation, and no permanent damage to the health and/or well-being of the subject following implantation as a result of the surgical procedure or presence of the implant.
Time frame: Through study completion, 5 years
Change in visual function
Visual function will be assessed with the implant "ON" vs. "OFF" using Basic Light Localization and Motion Test (BaLM/BaGA).
Time frame: Baseline, 1, 2, 3, 6, 9, 12, 18, 24, 30, 36, 42, 48, 52, 60 months post surgery
Change in Visual Acuity
Change in visual acuity will be measured with the implant "ON" vs "OFF" using Landolt C-optotypes.
Time frame: Baseline, 1, 2, 3, 6, 9, 12, 18, 24, 30, 36, 42, 48, 52, 60 months post surgery
Changes in response to photoflash test
Changes in response to photoflash test
Time frame: Baseline, 1, 2, 3, 6, 9, 12, 18, 24, 30, 36, 42, 48, 52, 60 months post surgery
Change in Activities of Daily Living
Changes in daily life situations will be assessed in a real world environment with the implant "ON" vs "OFF"
Time frame: Baseline, 1, 2, 3, 6, 9, 12, 18, 24, 30, 36, 42, 48, 52, 60 months post surgery
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