Retinas electrónicas contra la ceguera

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Médicos del Reino Unido han probado con éxito la eficacia de un implante electrónico para las personas con un tipo de ceguera. Se trata de un ensayo clínico que pretende probar una ‘retina’ artificial en 12 personas con retinosis pigmentaria, un trastorno congénito que conduce a la pérdida de visión. Los primeros resultados, conseguidos en dos pacientes, han sido llamativos ya que han logrado recuperar parte de su visión y ahora son capaces de distinguir luces y formas. No obstante, los expertos piden cautela ya que se trata de una técnica en experimentación.

Chris James y Robin Millar han sido las dos primeras personas que en el Reino Unido han conseguido recuperar su visión gracias a un dispositivo que una empresa alemana, Retina Implant AG, ha desarrollado y que ya probó con éxito en el país germano hace ahora dos años. Se trata de un chip electrónico de 1.500 píxeles sensibles a la luz con un tamaño de 3 milímetros cuadrados.

El dispositivo, que se implanta por detrás de la retina, suple la función de las células que están dañadas por la retinosis pigmentaria, una enfermedad hereditaria que afecta a unas 25.000 personas en nuestro país. De esta manera, los electrodos captan la luz y transmiten esa información al cerebro mediante un sistema de impulsos eléctricos.

«Los primeros síntomas de la retinosis pigmentaria suelen aparecer en la segunda o tercera década de la vida. En primer lugar, se produce una pérdida de la visión nocturna, después se va cerrando el campo visual y se atrofia el nervio óptico, para finalmente producir ceguera total», explica Luis Fernández-Vega, jefe del Servicio de Oftalmología del Hospital Central de Asturias y director médico del Instituto Oftalmológico Fernández-Vega de Oviedo.

Actualmente no existe ningún tratamiento para frenar o evitar la ceguera en las personas con esta enfermedad, de ahí que existan diferentes líneas de investigación en desarrollo para encontrar una terapia para estos pacientes.

Médicos del Reino Unido han probado con éxito la eficacia de un implante electrónico para las personas con un tipo de ceguera. Se trata de un ensayo clínico que pretende probar una ‘retina’ artificial en 12 personas con retinosis pigmentaria, un trastorno congénito que conduce a la pérdida de visión. Los primeros resultados, conseguidos en dos pacientes, han sido llamativos ya que han logrado recuperar parte de su visión y ahora son capaces de distinguir luces y formas. No obstante, los expertos piden cautela ya que se trata de una técnica en experimentación.

Chris James y Robin Millar han sido las dos primeras personas que en el Reino Unido han conseguido recuperar su visión gracias a un dispositivo que una empresa alemana, Retina Implant AG, ha desarrollado y que ya probó con éxito en el país germano hace ahora dos años. Se trata de un chip electrónico de 1.500 píxeles sensibles a la luz con un tamaño de 3 milímetros cuadrados.

El dispositivo, que se implanta por detrás de la retina, suple la función de las células que están dañadas por la retinosis pigmentaria, una enfermedad hereditaria que afecta a unas 25.000 personas en nuestro país. De esta manera, los electrodos captan la luz y transmiten esa información al cerebro mediante un sistema de impulsos eléctricos.

«Los primeros síntomas de la retinosis pigmentaria suelen aparecer en la segunda o tercera década de la vida. En primer lugar, se produce una pérdida de la visión nocturna, después se va cerrando el campo visual y se atrofia el nervio óptico, para finalmente producir ceguera total», explica Luis Fernández-Vega, jefe del Servicio de Oftalmología del Hospital Central de Asturias y director médico del Instituto Oftalmológico Fernández-Vega de Oviedo.

Actualmente no existe ningún tratamiento para frenar o evitar la ceguera en las personas con esta enfermedad, de ahí que existan diferentes líneas de investigación en desarrollo para encontrar una terapia para estos pacientes.

Antecedentes

La investigación que han presentado médicos del Hospital Oftalmológico de Oxford y del King’s College de Londres forma parte de un ensayo clínico iniciado en Alemania en 2010 que ha sido extendido a otros centros, dos en Alemania, uno en China y los dos mencionados de Reino Unido. De momento, sólo se han publicado los resultados del primer experimento que tuvo lugar en Alemania en noviembre de 2010 y cuyos resultados recogió la revista Proceedings of the Royal Society B donde se mostraba cómo los pacientes podía reconocer objetos y leer letras hasta formar palabras.

Imagen del chip colocado detrás del ojo. | H. Oftalmológico de Oxford
Ampliar foto. Imagen del chip colocado detrás del ojo. | H. Oftalmológico de Oxford

Tal y como han explicado los especialistas británicos, la operación duró unas ocho horas en la que se implantó en primer lugar un dispositivo que es el que emite la energía (similar a una pila), que se coloca detrás de la oreja, por debajo de la piel, y que es similar a un implante coclear. Posteriormente, se insertó la ‘retina’ electrónica por detrás del ojo que va unida con un cable a la pila. Ésta es precisamente una de las diferencias con el ensayo alemán ya que en aquel experimento la nueva retina del paciente sólo se activaba en el laboratorio, mientras que en el caso de los enfermos británicos se puede activar en cualquier lugar.

Tres semanas después de la operación, la retina de Chris se conectó por primera vez y fue capaz de distinguir la luz de la oscuridad. «Tan pronto como tuve este flash en mi ojo, confirmó que mi nervio óptico estaba funcionando adecuadamente lo que es una señal verdaderamente prometedora. Es algo parecido a cuando alguien hace una foto con un flash, una luz vibrante, que reconocí instantáneamente», ha explicado Chris.

Este paciente, de 54 años y que empezó a los 20 con ceguera nocturna, recibe un seguimiento médico cada mes. Entre visita y visita él sigue probando el microchip en casa. «Evidentemente, son los primeros días pero es esperanzador pues ya soy capaz de detectar luces algo que para mí era imposible«.

Promesas y cautela

Robert MacLaren, profesor de Oftalmología en la Universidad de Oxford y uno de los cirujanos que ha intervenido en este ensayo, reconoce «estar encantado con estos iniciales resultados. Estos pacientes no tenían percepción de la luz pero los implantes reactivaron su retina después de más de una década de ceguera. La visión es diferente de la normal… y requiere un proceso cerebral distinto. No obstante, esperamos que los chips electrónicos ofrezcan independencia para muchas personas que están ciegas por retinosis pigmentaria».

El otro paciente, Robin Millar, además de los avances conseguidos por Chris ha declarado que ahora también es capaz de soñar en color por primera vez en 25 años.

«El dispositivo no es útil en estos momentos para la degeneración macular, pero podría beneficiarles en un futuro», explica MacLaren. Para lo que no se podrá utilizar es para las enfermedades donde el nervio óptico está dañado, como en el glaucoma.

No obstante, tal y como advierte el oftalmólogo Fernández-Vega, «todavía es demasiado pronto como para establecer una opinión de esta técnica. Hace años hubo otro ensayo, con otro dispositivo distinto, del que se habló mucho en su momento pero que luego no progresó. No hay que dar falsas esperanzas a los pacientes. Como muy pronto, no habrá nada hasta dentro de cinco años. Además, existen otros ensayos en marcha con otras terapias, como la génica, o los trasplantes de células del epitelio pigmentario que, aunque también son experimentales, están en fases quizás más avanzadas. Hay que ser muy cautos».

Fuente: Periódico digital EL MUNDO

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