Brain-Computer Interfaces for Vision Recovery in Precortical Vision Loss.

Introduction: Precortical vision loss remains a major global health challenge. Advances in brain-computer interfaces (BCIs) offer a new pathway towards restoring functional vision by bypassing damaged structures in the visual pathway. Methods: This narrative review aims to synthesize the current evidence on BCIs for precortical vision recovery, including non-invasive and invasive techniques. Device design, testing, and outcomes are discussed, with an emphasis on developments in technology and engineering. Results: Non-invasive BCIs induce neuroplasticity and may restore vision in conditions of precortical vision loss such as glaucoma and optic neuropathy. Cortical visual prostheses demonstrate the ability to evoke visual precepts and recover functional vision. Integration of artificial intelligence and high-density electrode arrays has improved image encoding and device adaptability to enhance user experience and rehabilitation potential. Patient selection, safety, and long-term outcomes remain active areas of investigation. Discussion: BCIs present a paradigm shift in treating precortical blindness that offers hope for patients with no alternative options. Yet, challenges persist, including surgical risks, durability, and variability in response. Personalization of stimulation protocols and further technical refinement are needed to optimize efficacy and accessibility. Conclusion: BCIs are a promising experimental modality for precortical vision restoration. Continued research and interdisciplinary collaboration are essential to address current limitations.