Computer-Assisted Immersive Visual Rehabilitation in Argus II Retinal Prosthesis Recipients

Purpose: The field of retinal prostheses is expanding. However, the best approach to training and assessing the functional benefit of postoperative vision has not been established. The purpose of this single-center prospective interventional case series was to evaluate the feasibility and effectiveness of using the Computer Assisted Rehabilitation Environment (CAREN) system as a visual rehabilitation tool in Argus II patients. Design: Single-center prospective interventional case series (clinicaltrials.gov identifier, NCT03444961). Participants: Four Argus II recipients (3 men and 1 woman). Methods: Eight visual rehabilitation sessions using the CAREN system (twice weekly for 4 weeks). Main Outcome Measures: Baseline and postintervention assessments consisted of visual function, mobility, and balance tests. Results: All patients successfully completed training on the CAREN system. While the Argus II device was active, walking speed increased from baseline to immediately after the intervention on flat and undulating surfaces and while localizing objects by 20%, 10%, and 18%, respectively. An improved ability to complete the timed up and go test successfully was observed. Conclusions: Novel methods of visual rehabilitation for retinal prostheses recipients, such the CAREN system, are feasible and may result in improved ability to use the Argus II while performing functional tasks. Immersive technology may provide a solution for the standardization of effective rehabilitation approaches to augment retinal prosthesis performance. Heterogeneity of results indicates that a larger sample size would be beneficial. (C) 2019 by the American Academy of Ophthalmology