USC Eye Institute ophthalmologists implant first FDA-approved Argus II retinal prosthesis in western United States

LOS ANGELES, Aug. 27, 2014 /PRNewswire/ -- Lisa Kulik saw fireworks for the first time in nearly 30 years this July 4 holiday, thanks to a groundbreaking retinal implant co-invented by Mark Humayun, M.D., Ph.D., an internationally renowned clinician-researcher at the University of Southern California (USC) Eye Institute.

Kulik is a 55-year-old Peoria, Ariz. resident who has retinitis pigmentosa, a degenerative disease that progressively robs its victims of sight. On June 2, she became the first person west of the Mississippi to receive the FDA-approved Argus II retinal prosthesis, innovative wireless technology co-invented by Humayun, who is the Cornelius Pings Professor of Biomedical Sciences and professor of ophthalmology, biomedical engineering, cell and neurobiology at Keck Medicine of USC and the USC Viterbi School of Engineering.

When Kulik wore the Argus II to the July 4 celebration with her husband and niece, she didn't expect to see anything. But when the fireworks went off, so did flashes in her field of vision.

"My husband and niece were more excited than I was," she said. "I was seeing thick and thin flashes, and I knew it was the fireworks. I've also seen the moon, and I can see the contrast between the grass and the sidewalk.

"I'm hoping I will be able to see silhouettes of people, like my grandchildren, and be able to get around by myself. Losing independence has been the hardest part [of being blind] for me. I'd like to be able to take a walk down the street."

Kulik's progress is encouraging to Humayun, who started developing the Argus II more than 20 years ago.

"She could see spots of light on the first day of activation, which is very exciting," said Humayun, who is professor of ophthalmology and biomedical engineering at USC and co-director of the USC Eye Institute. The USC Eye Institute has ranked as a Top 10 ophthalmology program for 24 years and is No. 3 in research funding from the National Eye Institute. "That put her ahead of our expectations. Most of our patients haven't seen for decades and they have to relearn how to interpret visual signals, which takes quite a while. It's like seeing a baby learn to crawl, then to walk, then to run."

Kulik received the implant during a four-hour surgery at Keck Medicine of USC, performed by Lisa Olmos de Koo, assistant professor of ophthalmology at the Keck School, with Humayun assisting. Kulik is now undergoing several months of follow-up testing while she trains her brain to see in a new way. Some Argus II patients can see contrast well enough to sort light and dark clothing, and to see the outlines of doors, bushes, people and other objects.

The Argus II system uses a camera mounted on special glasses that sends a signal to an electronic receiver with 60 electrodes implanted inside the eye. The receiver sends signals to the retina that travel through the optic nerve to the brain, where they can be interpreted as a visual picture. Future applications of the device are aimed at age-related macular degeneration, a similar but more common disease than RP. The prosthesis is manufactured and sold by Second Sight Medical Products in Sylmar, California.

Clinical trials for the Argus II at USC began in 2007, with more than 30 patients implanted with the device as part of the trial. Eligible patients must be over the age of 25, have little or no light perception in both eyes and have had previous sight.

The Argus II is not just a professional goal for Humayun. As a medical school student, he was inspired to study blindness when complications from diabetes stole his grandmother's sight, and nothing could be done to help her.

"As her vision deteriorated, it was sad to see her losing the enjoyment she got through reading and being in her garden," he said. "That experience made me reconsider my path in medicine, and I obtained a Ph.D. in engineering so I could help restore sight to blind people."

Kulik began losing her sight in her late 20s, and by her early 30s, all she could see were shadows in extremely bright conditions. She had to give up her driver's license and quit her job at a veterinary clinic, working with the animals she loved. And she missed seeing her two sons, now 31 and 24, become men.

Her journey toward sight began in 2012, when her husband Ed saw an article on the Internet about the Argus II.  Kulik said Ed's discovery confirmed her continuous optimism that a solution to her blindness would be found.

"When I was diagnosed, I didn't let it stop me," she said. "I knew someone would come up with something."

Innovation is one of the hallmarks of the USC Eye Institute, a leader in National Eye Institute funding and ranked No. 9 in the United States for ophthalmology care by U.S. News & World Report. The Argus II is one of many examples of how the interdisciplinary environment at USC enables the creation of potential miracle solutions to health problems.

"One of USC's strengths is that we have an extraordinarily collaborative environment with world-class expertise in many different areas that can impact our health — including medicine, engineering, pharmacy, interactive media and public policy," said Rohit Varma, M.D., M.P.H., director of the USC Eye Institute and chair, Department of Ophthalmology, Keck School of Medicine of USC. "The Argus II is one of the prime examples of such a collaboration, resulting from a strong relationship with the Keck School of Medicine of USC and the USC Viterbi School of Engineering. 

"Losing sight is devastating to most people, making them depressed, more dependent on others and reducing their social interactions and productivity, among other things," Varma added. "Now with the Argus II we have the potential to reverse all that and help people begin new, more independent, productive and fuller lives. By bringing sight back to the blind, the Argus II is truly a miracle."

Retinitis pigmentosa (RP) is a genetic disease affecting nearly 100,000 people in the U.S. Those with the disease experience progressive loss of photoreceptors (rods and cones) or the retinal pigment epithelium, a pigmented cell layer that nourishes retinal cells. As the disease progresses, patients experience night blindness, tunnel vision, blurring, and difficulty adjusting from dark to light environments. Eventually their vision is reduced to shadows and most victims are declared legally blind.

Kulik is also participating in a study to determine whether partial restoration of vision has an impact on how the brain processes information. She returns to USC periodically for magnetic imaging resonation (MRI) tests, as well as testing with the Argus II.

ABOUT USC EYE INSTITUTE:
The USC Eye Institute has consistently ranked as a Top 10 ophthalmology program by U.S. News & World Report and Ophthalmology Times and is No. 3 in research funding from the National Eye Institute. Led by Rohit Varma, M.D., M.P.H., the USC Eye Institute has 21 full-time faculty physicians covering all subspecialties of ophthalmology. The USC Eye Institute is headquartered near downtown Los Angeles and has satellite clinics in Pasadena, Beverly Hills and Arcadia. For more information, go to eye.keckmedicine.org.

ABOUT KECK MEDICINE OF USC
Keck Medicine of USC is the University of Southern California's medical enterprise, one of only two university-based medical systems in the Los Angeles area. Encompassing academic, research and clinical excellence, the medical system attracts internationally renowned experts who teach and practice at the Keck School of Medicine of USC, the region's first medical school; includes the renowned USC Norris Comprehensive Cancer Center, one of the first comprehensive cancer centers established by the National Institutes of Health (NIH) in the United States; has a medical faculty practice, the USC Care Medical Group; operates the Keck Medical Center of USC, which includes two acute care hospitals: 401-licensed bed Keck Hospital of USC and 60-licensed bed USC Norris Cancer Hospital; and owns USC Verdugo Hills Hospital, a 158-licensed bed community hospital. It also includes more than 40 outpatient facilities, some at affiliated hospitals, in Los Angeles, Orange, Kern, Tulare and Ventura counties. For more information, go to www.keckmedicine.org/beyond

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SOURCE Keck Medicine of USC