Methods for improving damaged retinal cell function using physical and/or mechanical stimulation

Abstract

Methods of using physical stimulation by itself or in conjunction with growth factors to treat and prevent visual loss due to choroidal, retinal pigment epithelial and/or neuroretinal cell degeneration and dysfunction are presented.

1 . A method of improving visual function of a damaged and/or degenerating retina in a human eye, the method comprising: 
 applying at least one of a chronic physical and mechanical stimulation to the eye to improve or maintain visual function of the retina, wherein applying the at least one of the chronic physical and mechanical stimulation improves visual function of at least one structure of the damaged retina.    
     
     
         2 . The method of  claim 1 , wherein the improved visual function comprises at least one of improved perception of light in the presence of light, improved perception of darkness in the presence of darkness, improved perception of contrast, color, shape, resolution, movement and visual field size.  
     
     
         3 . The method of  claim 1 , wherein the chronic physical stimulation is applied by a source of physical stimulation comprising at least one device in contact with any structure of the eye.  
     
     
         4 . The method of  claim 1 , wherein the chronic physical stimulation is provided to at least one of the damaged retina and a structure of the eye.  
     
     
         5 . The method of  claim 3 , wherein the at least one device comprises a plurality of devices.  
     
     
         6 . The method of  claim 3 , wherein the at least one device comprises one of an electrically inert device, a chemical agent and a biological agent.  
     
     
         7 . The method of  claim 1 , wherein the source of physical stimulation comprises a device having at least one photoactive surface electrically connected to at least one stimulating electrode.  
     
     
         8 . The method of  claim 7 , wherein the photoactive surface comprises at least one photodiode, photovoltaic device or photoelectric device.  
     
     
         9 . The method of  claim 8 , wherein the at least one photodiode comprises a plurality of photodiodes, photovoltaic devices or photoelectric devices.  
     
     
         10 . The method of  claim 3 , wherein the at least one device is implanted surgically into a subretinal space at an angle between about 5° and 80° off-axis from a macula, wherein the angle is defined by an intersection of an axis line extending from the macula to a central structure of a pupil and an off-axis line extending from the device to the central structure of the pupil.  
     
     
         11 . The method of  claim 3 , wherein the at least one device is surgically implanted in at least one area of the damaged retina, excluding a macula.  
     
     
         12 . The method of  claim 3 , wherein the at least one device comprises at least one fenestration.  
     
     
         13 . The method of  claim 1 , wherein the damaged retina is the result of at least one condition selected from the group consisting of age-related macular degeneration, retinitis pigmentosa, choroidal disease, choroidaremia, long-term retinal detachment, diabetic retinopathies, Stargardt's retinopathy, Leber's congenital amaurosis, Best's Disease, choroidal rupture, and choroidal disease.  
     
     
         14 . A method of treating visual degradation resulting from a damaged retina, wherein the visual degradation comprises primary or secondary degradation, the method comprising: 
 applying chronic physical stimulation to an eye containing the damaged retina.    
     
     
         15 . The method of  claim 14 , wherein the damaged retina comprises a damaged cell comprising at least one of a photoreceptor cell, choroidal vasculature cell, retinal pigment epithelial cell, bipolar cell, horizontal cell, amacrine cells and ganglion cells; and 
 wherein at least one portion of the damaged cell is treated.    
     
     
         16 . The method of  claim 15 , wherein the at least one portion that is treated comprises at least one portion of an undamaged cell.  
     
     
         17 . The method of  claim 15 , wherein the at least one portion that is treated comprises a portion not in physical contact with a source of chronic physical stimulation.  
     
     
         18 . The method of any of claims  14 - 17 , wherein the physical stimulation is provided to at least one of the damaged retina and a structure of the eye.  
     
     
         19 . The method of  claim 14 , wherein applying chronic physical stimulation comprises placing a source of physical stimulation in contact with the eye, the source of physical stimulation comprising at least one device.  
     
     
         20 . The method of  claim 19 , wherein the at least one device is in contact with the retina, and the applying physical stimulation treats at least one of a structure of the damaged retina peripheral to the portion of the retina in contact with the at least one device and a portion of the damaged retina in contact with the device.  
     
     
         21 . The method of  claim 19 , wherein the at least one device comprises a plurality of devices.  
     
     
         22 . The method of  claim 19 , wherein the at least one device comprises one of an electrically inert object, a chemical agent and a biological agent.  
     
     
         23 . The method of  claim 19 , wherein the at least one device comprises at least one photoactive surface electrically connected to at least one stimulating electrode.  
     
     
         24 . The method of  claim 23 , wherein the at least one photoactive surface comprises at least one photodiode, photovoltaic device or photoelectric device.  
     
     
         25 . The method of  claim 24 , wherein the at least one photoactive surface comprises a plurality of photodiodes, photovoltaic devices, or photoelectric devices.  
     
     
         26 . The method of  claim 19 , wherein the at least one device is implanted surgically into a subretinal space at an angle between about 5° and 80° off-axis from a macula, wherein the angle is defined by an intersection of an axis line extending from the macula to a central structure of a pupil, and an off-axis line extending from the device to the central structure of the pupil.  
     
     
         27 . The method of  claim 19 , wherein the at least one device is surgically implanted in at least one area of the retina, excluding a macula.  
     
     
         28 . The method of  claim 14 , wherein the physical stimulation is intermittent.  
     
     
         29 . The method of  claim 14 , wherein said damaged retina is the result of at least one condition selected from the group consisting of age-related macular degeneration, retinitis pigmentosa, choroidal disease, choroidaremia, long-term retinal detachment, diabetic retinopathies, Stargardt's retinopathy, Leber's congenital amaurosis, Best's Disease and choroidal rupture.  
     
     
         30 . A method of improving visual function in a damaged macula of a human eye, the method comprising: 
 selecting at least one electrically inert device;    implanting the at least one electrically inert device in a subretinal space in the eye; and wherein the device is positioned peripheral to the macula of the eye and in the subretinal space.    
     
     
         31 . The method of  claim 30 , wherein implanting the at least one electrically inert device comprises implanting the device at a position in the subretinal space at an angle between about 5° and 80° off-axis from the macula, wherein the angle is defined by an intersection of an axis line extending from the macula to a central structure of the pupil and an off-axis line extending from the device to the central structure of the pupil.  
     
     
         32 . The method of  claim 30 , wherein implanting the device further comprises implanting the device in a temporal half retina region of the eye.  
     
     
         33 . The method of  claim 30 , wherein implanting the device further comprises implanting the device in a nasal half retina region of the eye.  
     
     
         34 . The method of  claim 30 , wherein selecting at least one electrically inert device comprises selecting a plurality of electrically inert devices, and wherein implanting the at least one device comprises implanting the plurality of electrically inert devices.  
     
     
         35 . The method of  claim 34 , wherein implanting each of the plurality of electrically inert devices comprises implanting each of the plurality of electrically inert devices at a respective position in the subretinal space at an angle between about 50 and 800 off-axis from the macula, wherein the angle is defined by an intersection of an axis line extending from the macula to a central structure of the pupil and an off-axis line extending from the device to the central structure of the pupil.  
     
     
         36 . The method of  claim 34 , wherein implanting the plurality of electrically inert devices further comprises implanting the plurality of electrically inert devices in a temporal region of the eye.  
     
     
         37 . The method of  claim 34 , wherein implanting the plurality of electrically inert devices further comprises implanting the plurality of electrically inert devices in a nasal region of the eye.  
     
     
         38 . The method of  claim 34 , wherein the plurality of electrically inert devices are implanted symmetrically around a region centered by the macula.  
     
     
         39 . A method of implanting an physically stimulating device in an eye of a patient having least one condition selected from the group consisting of outer neuroretina disease, choroidal disease and retinal epithelial disease, the method comprising: 
 implanting in a subretinal space in the eye of the patient at least one electrically inert device configured to contact a plurality of cells in the eye.    
     
     
         40 . The method of  claim 39 , wherein the device is positioned in one of a peripheral or mid-peripheral region in the subretinal space outside of a macula of the eye.  
     
     
         41 . The method of  claim 39 , wherein implanting the device comprises implanting the device at a position in the subretinal space at an angle between about 50 and 800 off-axis from the macula, wherein the angle is defined by an intersection of an axis line extending from the macula to a central structure of the pupil and an off-axis line extending from the device to the central structure of the pupil.  
     
     
         42 . The method of  claim 39 , wherein implanting the device further comprises implanting the device in a temporal half retina region of the eye.  
     
     
         43 . The method of  claim 39 , wherein implanting the device further comprises implanting the device in a nasal half retina region of the eye.  
     
     
         44 . The method of  claim 39 , wherein the condition is selected from the group consisting of age-related macular degeneration, retinitis pigmentosa, choroidal disease, choroidaremia, long-term retinal detachment, diabetic retinopathies, Stargardt's retinopathy, Leber's congenital amaurosis, Best's Disease and choroidal rupture.  
     
     
         45 . The method of  claim 39 , wherein implanting the at least one electrically inert device comprises implanting the plurality of devices.  
     
     
         46 . Use of a source of physical stimulation for producing an implant for improving the visual function of a damaged retina in a human eye by applying chronic physical stimulation to the eye,  
     
     
         47 . The use of  claim 46 , wherein applying chronic physical stimulation improves visual function of at least one structure which is not in contact with the source of physical stimulation.  
     
     
         48 . The use of  claim 46 , wherein the improved visual function comprises at least one of improved perception of light in the presence of light, and improved perception of darkness in the presence of darkness, improved perception of contrast, color, shape, resolution, movement and visual field size.  
     
     
         49 . The use of  claim 46 , wherein the source of physical stimulation comprises at least one device in contact with any structure of the eye.  
     
     
         50 . The use of  claim 46 , wherein the physical stimulation is provided to at least one of the damaged retina and a structure of the eye.  
     
     
         51 . The use of  claim 46 , wherein the at least one device is adapted to be in contact with the damaged retina, and the applying chronic physical stimulation improves the visual function of at least a structure of the damaged retina peripheral to a portion of the retina in contact with the at least one device.  
     
     
         52 . The use of  claim 49 , wherein the at least one device comprises a plurality of devices.  
     
     
         53 . The use of  claim 49 , wherein the at least one device comprises an electrically inert device.