Tuesday, March 25, 2025

OPTIC NERVE STIMULATION (ONS) THERAPY

 


An innovative approach to glaucoma treatment is electrical stimulation of the retina and optic nerve.

In a study by Gall, transcutaneous electrical stimulation was applied through supra- and infra-orbital electrodes to the eyes of 82 patients diagnosed with optic neuropathies. The treated group had a significant improvement in visual field of 24% compared to baseline. This improvement persisted for at least 2 months. [1]

Another study by Ota involved five eyes of four patients suffering from POAG, who underwent transcorneal electrical stimulation. There was a significant linear relationship between changes in MD values and the number of electrical stimulation sessions, indicating partially restored visual fields (p < 0.01). [2]

However, a study by Rock in which transcorneal electrical stimulation was done the results were equivocal. Patients were randomized into three groups with no stimulation (sham), and electrical stimulation intensities below (subthreshold) or above (suprathreshold) individual phosphene thresholds. No statistically significant differences in visual fields between groups were reported. [3]

A study of optic nerve stimulation (ONS) by Erb et al involved 101 eyes in 70 patients (31 female, 39 male). The subjects included primary open-angle glaucoma (POAG, 65), normal tension glaucoma (NTG, 13), angle-closure glaucoma (ACG, 6), pseudoexfoliative glaucoma (PEX, 6), juvenile glaucoma (4), pigmentary glaucoma (4), glaucoma fere absolutum (2), and congenital glaucoma (1). [4]

The ONS treatment was conducted using the Eyetronic® device (Neuromodtronic GmbH, Potsdam, Germany) that applied electrical stimulation via goggles with embedded supraorbital and infraorbital electrodes and recorded EEG signals via an electrode cap.

The study revealed a significant change of MD by − 0.5 dB/year on average in visual field testing. MD significantly decreased from PRE 14.0 dB (median) to POST 13.4 dB (p < 0.01). 64 eyes in 49 patients showed constant or reduced MD as compared to baseline (PRE 13.4 dB vs. POST 11.2 dB). In 37 eyes of 30 patients, MD increased from PRE 14.9 dB to POST 15.6 dB.

Median MD at baseline before ONS treatment was 14 dB, more than 58% of eyes had an advanced vision loss with an MD > 12 dB, more than 80% of eyes were classified as moderate or advanced glaucoma, corresponding to an MD ≥ 6 dB.

The Eyetronic therapy involves the application of gentle electrical pulses, which stimulate the metabolism of neurons, restoring their function and stopping further cellular degeneration.

The therapy involves 10 sessions of 60 minutes each, applied over 10 consecutive days.






WEBSITE: https://eyetronic-therapie.de/en/

REFERENCES:

  1. Gall C, Schmidt S, Schittkowski MP, Antal A, Ambrus GG, Paulus W, et al. Alternating current Stimulation for vision restoration after optic nerve damage: a randomized clinical trial. PLoS One. 2016;11(6):e0156134.
  2. Ota Y, Ozeki N, Yuki K, Shiba D, Kimura I, Tsunoda K, et al. The efficacy of Transcorneal electrical Stimulation for the treatment of primary open angle Glaucoma: a pilot study. Keio J Med. 2018;67(3):45–53.
  3. Rock T, Naycheva L, Willmann G, Wilhelm B, Peters T, Zrenner E, et al. Transcorneal electrical stimulation in primary open angle glaucoma. Ophthalmologe. 2017;114(10):922–9.
  4. Erb C, Eckert S, Gindorf P, Köhler M, Köhler T, Neuhann L, Neuhann T, Salzmann N, Schmickler S, Ellrich J. Electrical neurostimulation in glaucoma with progressive vision loss. Bioelectron Med. 2022 Mar 31;8(1):6. doi: 10.1186/s42234-022-00089-9. PMID: 35361287; PMCID: PMC8969331

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OPTIC NERVE STIMULATION (ONS) THERAPY

  An innovative approach to glaucoma treatment is electrical stimulation of the retina and optic nerve. In a study by Gall, transcutaneous...