合成視覺有望讓盲人復明

More than half a century ago, when he was just 18 years old, Georges* learned that he had retinitis pigmentosa. He was told that his vision would progressively deteriorate until he was blind. As predicted, when Georges reached his early fifties, his world went completely dark. Last year, at the push of a button, Georges suddenly saw light again. “When they got the electrodes going, it was a real fireworks show,” he exclaims.

50多年前，當喬治斯還是個18歲的小夥子時，不幸患上了色素性視網膜炎。他被告知視力將逐漸退化，直至全盲。不出所料，到了50多歲時，他的世界變得完全漆黑一片。但是去年，就在一個按鈕被按下的瞬間，喬治斯突然重新見到了光明。他驚呼道：“當他們通上電以後，感覺真的就像煙花表演一樣。”

Georges is part of a pilot program testing Iris, a product to restore vision to blind people, made by a young French company called Pixium Vision. The company’s founder, Bernard Gilly, is a scientist-turned-entrepreneur with a network of businesses focused on using technologies to improve human health, mostly around the nervous system.

這款神奇的產品名叫Iris系統，旨在幫助盲人恢復視力。它是由一家名叫Pixium Vision，成立沒多久的法國企業開發的，喬治斯正是首批試驗該設備的病人之一。該公司的創始人伯納德o吉利原本是一位科學家，旗下擁有多家致力於利用科技（大多圍繞神經系統）改善人體健康的企業。

“Ophthalmology seemed like a good way to approach the central nervous system because the eye, and especially the retina, is like a visible part of the brain,” Gilly says, noting that France counts 200,000 people in the country who are blind or nearly blind, and that generally there is no cure. “People are unaware of how prevalent the condition is because there are not many blind people in the streets. They are more prone to accidents, so they tend to stay home.”

吉利指出：“眼科是研究人體中樞視經系統的一個好途徑，因爲眼睛、特別是視網膜，就像是大腦的一個可見部分。”他指出，法國有約20萬人處於全盲或接近全盲，而且基本上是沒法治癒的。“很多人不瞭解這種情況有多普遍，這是因爲我們在街上看不到很多盲人，因爲他們在室外容易發生事故，所以他們傾向於待在家裏。”

Technological advances such as microbiology and microelectronics are creating new opportunities to restore sight, Gilly says, and scientists are making enormous strides in understanding the workings of the brain. It’s long been known that electricity can stimulate the nervous system, and a technique called “neuromodulation” is being used to address everything from Parkinson’s disease to chronic pain. Now, it can treat blindness, too.

吉利表示，微生物學與微電子學等領域的技術進步，爲盲人復明帶來了新的希望。另外科學家也付出了大量努力來理解大腦的工作機制。我們很久以前就知道電流可以刺激人的神經系統，另外，我們已經開始使用一種叫做“神經調節”的技術來治療帕金森症和各種慢性疼痛。現在，這項技術也能治療眼盲了。

The best candidates for Iris are patients with degenerative eye conditions. A surgeon implants a tiny silicon chip with 150 electrodes on the retina. Afterwards, the patient wears a pair of dark glasses with an integrated video camera that sends images to a portable mini-computer. This computer transforms the pictures into digital signals, which are sent back to the glasses, then transmitted wirelessly to a receiver on the implant. Pulses activate the electrodes, and the optic nerve carries the images to the brain.

最適合使用Iris的是那些患有退化性眼病的患者。醫生向患者的視網膜內植入一塊帶有150個電極的微小芯片。手術後，患者需要戴上一副專用的墨鏡，其中的集成攝像機可以向一臺微型便攜電腦傳送圖像。這臺電腦隨後把圖像轉換成數字信號，回傳到墨鏡上，然後再無線傳輸至植入芯片的接收器上。電子脈衝會激活電極，人的視神經便會將圖像傳送到大腦。

After surgery, patients follow a program of rehabilitation to teach their brains how to interpret these new images. What they see is basic shapes in variations of black, white, and gray. (The resolution is still too low for them to distinguish facial features or read.)

在接受手術後，患者需要參加一個康復項目，以教會他們的大腦如何解讀這些新的圖像。他們所見到的只是一些黑白灰色的基本形狀。（這套解決方案目前尚不能讓患者重新閱讀或識別面部特徵。）

“We don’t give them back their sight, but another way of seeing,” says Yannick Le Mer, the surgeon who implanted the system in three of Pixium’s test subjects. Le Mer says it is impossible to know beforehand how anyone will react, since it depends on each brain’s adaptability—like learning to play the piano or speak Japanese. Some catch on immediately, while others struggle.

亞尼克o拉o梅爾已經將這套系統植入三名測試者的眼球中。他表示：“我們沒有讓他們重獲視力，但提供了另一種讓他們看見的辦法。”拉o梅爾表示，目前無法知道每名患者的反應如何，因爲它取決於每個大腦的適應性——就像學鋼琴或學日語一樣，有的人學得很快，但也有人學得非常慢。

One recent autumn day, Georges, a small, soft-spoken man, traveled from his home in Brittany to the Quinze-Vingts hospital in eastern Paris. A young therapist named Alexandre Leseigneur was waiting for him, and the two spent the day together practicing using the system in the corridors. (The glasses were not yet available for practice at home.)

去年秋天，一位個頭不高，說話輕聲軟語的男人從布列塔尼老家來到了巴黎東部的Quinze-Vingts眼科醫院。他就是喬治斯。一位名叫亞歷山大的醫生正在等着他。他們在醫院走廊裏用了兩天時間學習怎樣使用這套系統。（目前這套系統還不能用於在家練習）。

Georges put the glasses on and hung a strap with the computer over his shoulder. The first time they went into the hallway, he moved hesitantly, shuffling sideways and reaching out his hand. “The flashes are too bright. I’m lost,” he said. Leseigneur plugged the glasses into a laptop computer, adjusted the settings, and they went out again. This time was better. Following a black band on the floor, Georges walked the length of a corridor and even managed to avoid an obstacle blocking his path.

喬治斯戴上了眼鏡，用一根帶子把電腦挎在了肩上。第一次，他們先去了走廊。喬治斯移動得很猶豫，腳步蹣跚地向前蹭着，伸手摸着。他說：“光線太亮了，我迷路了。”亞歷山大將墨鏡插到一臺筆記本電腦上，調整了設置，然後他們又出去了。這一次好了一些。沿着地上的黑色圖案，喬治亞走完了一個走廊的長度，甚至還繞過了路上的一個障礙物。

Gilly estimates that when the Iris arrives on the European market in late 2015, the cost to each patient will be around 100,000 euros, plus surgery. Though that might sound expensive, he says it’s a bargain compared to the price of blindness. A study at the University of Chicago forecasts that in the United States alone, costs related to eye disease and vision problems will reach $717 billion by 2050.

吉利預測稱，等到Iris系統2015年末正式投放歐洲市場，每名患者的成本大概會在10萬歐元左右，另外再加上手術費。雖然這筆費用聽起來很貴，但吉利表示，和失明相比，花這筆錢還是很划算的。芝加哥大學的一項研究表明，光是在美國，到2050年，由眼病和視力問題導致的成本就將高達7170億美元。

Last June, Pixium made an initial public offering, raising nearly 40 million euros (more than $53 million) from European investors. It is not the only company working in this field. Various permutations of what is commonly called a “bionic eye”—Gilly dislikes the term—are being developed from Germany to Australia. The pioneer is an American company, Second Sight Medical, which earned European approval for its Argus II system in 2011 and FDA approval in 2013. In November, Second Sight had its own successful IPO, raising some $32 million.

去年六月，Pixium公司進行了IPO，從歐洲投資人手中融資近4000萬歐元（約合5300多萬美元）。Pixium並不是唯一一家從事失明領域研究的企業。從德國到澳大利亞，許多企業都在開發俗稱的“仿生眼”。其中一家名叫“第二視覺醫療公司”（Second Sight Medical）的美國企業走得最遠，它的Argus II系統已經於2011年通過了歐洲認證，又於2013年通過了FDA(美國食物及藥品管理局)認證。去年11月，第二視覺公司也成功進行了IPO，融資約3200萬美元。

While the Iris is very similar to the Argus II, Gilly mentions a few key differences. His camera, for example, captures only the changes in the environment, so that the overall view is continuous, closer to the way the human eye actually sees. The implant can also be easily removed and replaced with upgrades as they become available.

雖然Iris與Argus II系統非常類似，但吉利也指出了一些不同之處。比如Iris的攝像頭只捕捉環境的變化，所以它的總體視覺是持續不斷的，更貼近真實人眼的視覺模式。另外，眼內的植入物也可以被輕易移除並更換升級版。

The company’s next generation product, Prima, will start clinical trials in 2016. With at least 10 times as many electrodes, it should enable people to read and to see facial features. “Patients tell us that what they want first is autonomy and safety,” says Gilly. “After that, they want to be able to recognize their loved ones, to see their spouses or their grandchildren.”

該公司的下一代產品Prima將於2016年開始臨牀測試。Prima的電極比Iris多了10倍，應該可以讓失明者重新恢復閱讀和識別面部特徵的能力。吉利表示：“病人告訴我們，他們首先想要的是自主性和安全性。其次，他們希望能夠認出他們所愛的人，看到他們的愛人或孫子。”

Since this is synthetic vision, the possibilities are vast. Soon the technology will permit users to see as clearly at night as during the day. A future device might be able to transmit the contents of an e-book or a movie directly to the retina. For now, Le Mer says, the goal is simply to help someone locate a door in a room. “It seems modest, but it’s huge.”

由於它是一種合成視覺，因此它擁有廣闊的可能性。很快，這項技術就可以讓用戶“視黑夜如白晝”。未來的某款設備甚至有可能直接將一本電子書或電影的內容投射到人的視網膜上。不過拉o梅爾表示，他們目前的目標還只是幫助盲人找到一間屋子的門。“看起來似乎不是很宏大的目標，但意義非常重大。”

Georges agrees. He tells about how not long ago he was taking a walk near his home. “There was a truck parked across the sidewalk. My cane slipped under it, so I didn’t know it was there, and I smacked my head. If I had been using this system, I would have seen it.”

喬治斯也同意這一點。他告訴我們，前不久在他家附近散步時，“人行道對面停了一輛卡車，我的手杖探到車子下面去了，所以我不知道車子停在那兒，結果撞到了頭。如果當時我已經用上了這個系統，我就會看到它了。”（財富中文網）