Francesca Cordeiro - Academia.edu (original) (raw)

Papers by Francesca Cordeiro

Scientific Reports

Here, we have developed a deep learning method to fully automatically detect and quantify six mai... more Here, we have developed a deep learning method to fully automatically detect and quantify six main clinically relevant atrophic features associated with macular atrophy (MA) using optical coherence tomography (OCT) analysis of patients with wet age-related macular degeneration (AMD). The development of MA in patients with AMD results in irreversible blindness, and there is currently no effective method of early diagnosis of this condition, despite the recent development of unique treatments. Using OCT dataset of a total of 2211 B-scans from 45 volumetric scans of 8 patients, a convolutional neural network using one-against-all strategy was trained to present all six atrophic features followed by a validation to evaluate the performance of the models. The model predictive performance has achieved a mean dice similarity coefficient score of 0.706 ± 0.039, a mean Precision score of 0.834 ± 0.048, and a mean Sensitivity score of 0.615 ± 0.051. These results show the unique potential of ...

Acta Ophthalmologica

The realization that lowering IOP is unable to prevent progressive vision loss in all glaucoma pa... more The realization that lowering IOP is unable to prevent progressive vision loss in all glaucoma patients, has led to investigation of neuroprotection as an alternative or additional treatment option. Although confirmation of neuroprotective effects by randomized clinical trials is needed, there was a demonstration of positive non‐IOP dependent effects in the LoGTS study, although negative published results of the Memantine study. Much optimism exists for the potential of nicotinamide. Furthermore, it has been proposed as a treatment strategy in other ocular diseases, such as AMD. Neuroprotection has been advocated for many years in neurodegeneration. Indeed, the therapies that have been suggested in Alzheimer's and Parkinson's Disease are similar to those investigated in ophthalmology. This talk will review the evidence for neuroprotection and its role in glaucoma and application as a practical and future treatment strategy.

Lab on a Chip

We develop a quantitative lateral flow assay (LFA) device that is able to measure the tear level ... more We develop a quantitative lateral flow assay (LFA) device that is able to measure the tear level of brain derived neurotrophic factor (BDNF). The device shows great potential to serve as an ideal platform for early detection of glaucoma.

Investigative Opthalmology & Visual Science, 2021

Purpose To report novel genotypes and expand the phenotype spectrum of SSBP1-disease and explore ... more Purpose To report novel genotypes and expand the phenotype spectrum of SSBP1-disease and explore potential disease mechanism. Methods Five families with previously unsolved optic atrophy and retinal dystrophy underwent whole genome sequencing as part of the National Institute for Health Research BioResource Rare-Diseases and the UK's 100,000 Genomes Project. In silico analysis and protein modelling was performed on the identified variants. Deep phenotyping including retinal imaging and International Society for Clinical Electrophysiology of Vision standard visual electrophysiology was performed. Results Seven individuals from five unrelated families with bilateral optic atrophy and/or retinal dystrophy with extraocular signs and symptoms in some are described. In total, 6 SSBP1 variants were identified including the previously unreported variants: c.151A>G, p.(Lys51Glu), c.335G>A p.(Gly112Glu), and c.380G>A, p.(Arg127Gln). One individual was found to carry biallelic variants (c.380G>A p.(Arg127Gln); c.394A>G p.(Ile132Val)) associated with likely autosomal recessive SSBP1-disease. In silico analysis predicted all variants to be pathogenic and Three-dimensional protein modelling suggested possible disease mechanisms via decreased single-stranded DNA binding affinity or impaired higher structure formation. Conclusions SSBP1 is essential for mitochondrial DNA replication and maintenance, with defects leading to a spectrum of disease that includes optic atrophy and/or retinal dystrophy, occurring with or without extraocular features. This study provides evidence of intrafamilial variability and confirms the existence of an autosomal recessive inheritance in SSBP1-disease consequent upon a previously unreported genotype.

Expert Review of Precision Medicine and Drug Development, 2020

Introduction: Personalised medicine is the future goal across all specialities. Accurate predicti... more Introduction: Personalised medicine is the future goal across all specialities. Accurate prediction of optimal treatment beneficial and adverse effects could transform patient management. This is of particular importance in chronic conditions, where a 'trial and error' approach over months and years can contribute to significant morbidity. Glaucoma is a chronic irreversible progressive optic neuropathy, a leading cause of blindness worldwide. An ideal personalised approach in glaucoma clinic would be to answer the inevitable question in a patient's first visit: 'Which treatment option will work best for me so that I won't go blind?' Areas covered: This review will give an overview of the knowledge we have acquired to achieve this goal, particularly discussing using patient's individual risk factors, their genetic profile and different treatment modalities, including therapy compliance, to personalise care. Expert opinion: Pharmacogenomics and genetic profiling are the most tangible ways in which glaucoma management can be personalised. Future challenges will include developing realistic animal models to reflect the underlying genetic patterns in glaucoma that to investigate their interaction with different treatments.

Alzheimer's & Dementia, 2020

The last decade has seen a substantial increase in research focused on the identification, develo... more The last decade has seen a substantial increase in research focused on the identification, development, and validation of diagnostic and prognostic retinal biomarkers for Alzheimer's disease (AD). Sensitive retinal biomarkers may be advantageous because they are cost and time efficient, non‐invasive, and present a minimal degree of patient risk and a high degree of accessibility. Much of the work in this area thus far has focused on distinguishing between symptomatic AD and/or mild cognitive impairment (MCI) and cognitively normal older adults. Minimal work has been done on the detection of preclinical AD, the earliest stage of AD pathogenesis characterized by the accumulation of cerebral amyloid absent clinical symptoms of MCI or dementia. The following review examines retinal structural changes, proteinopathies, and vascular alterations that have been proposed as potential AD biomarkers, with a focus on studies examining the earliest stages of disease pathogenesis. In addition...

Ophthalmic Research, 2019

Purpose: To define unmet needs in ophthalmology that can realistically be addressed in the next 5... more Purpose: To define unmet needs in ophthalmology that can realistically be addressed in the next 5 years (2019–2025) and describe potential avenues for research to address these challenges. Methods: Outcomes of a consensus process within the European Vision institute (Brussels) are outlined. Disease areas that are discussed comprise glaucoma, retinal dystrophies, diabetic retinopathy, dry eye disease, corneal diseases, cataract and refractive surgery. Results: Unmet needs in the mentioned disease areas are discussed and realistically achievable research projects outlined. Conclusions: Considerable progress can be made in the ophthalmic field and patient-relevant outcomes in the near future.

Acta Ophthalmologica, 2018

better visual performance. In addition, AS-OCT-guided non-contact excimer laser deep anterior lam... more better visual performance. In addition, AS-OCT-guided non-contact excimer laser deep anterior lamellar keratoplasty (DALK) may avoid the disadvantages of conventional DALK in case of conversion for young keratoconus patients. Femtosecond laser application is always performed with a mechanical coupling and induces deformation of the cornea due to suction. Therefore, results of femtosecond laser supported keratoplasty results in more decentration, donor-host disparity and higher amount of astigmatism and topographic irregularityespecially in advanced keratoconus. Nevertheless, it is considered state-of-the-art for LASIK flaps and indispensable for intrastromal ring segments in keratoconus. Recently, the picosecond infrared laser (PIRL) a new promising technology for applanation-free corneal trephination has been introduced. In the future a "non-contact" femtosecond laser system for corneal trephination might be considered.

Frontiers in neurology, 2016

Alzheimer's disease (AD) is the most common form of dementia affecting the growing aging popu... more Alzheimer's disease (AD) is the most common form of dementia affecting the growing aging population today, with prevalence expected to rise over the next 35 years. Clinically, patients exhibit a progressive decline in cognition, memory, and social functioning due to deposition of amyloid β (Aβ) protein and intracellular hyperphosphorylated tau protein. These pathological hallmarks of AD are measured either through neuroimaging, cerebrospinal fluid analysis, or diagnosed post-mortem. Importantly, neuropathological progression occurs in the eye as well as the brain, and multiple visual changes have been noted in both human and animal models of AD. The eye offers itself as a transparent medium to cerebral pathology and has thus potentiated the development of ocular biomarkers for AD. The use of non-invasive screening, such as retinal imaging and visual testing, may enable earlier diagnosis in the clinical setting, minimizing invasive and expensive investigations. It also potentiall...

Current opinion in molecular therapeutics, 2003

Cambridge Antibody Technology is developing lerdelimumab (CAT-152), the lead in a series of human... more Cambridge Antibody Technology is developing lerdelimumab (CAT-152), the lead in a series of human anti-TGF beta 2 antibodies, for its potential in preventing post-operative scarring in patients undergoing surgery for glaucoma (trabulectomy). It also has potential for the treatment of fibrosis, cataract, retinopathy and connective tissue disease.

Progress in Retinal and Eye Research, 2002

The introduction of the anti-cancer drugs Mitomycin and 5-fluorouracil as anti-scarring agents wi... more The introduction of the anti-cancer drugs Mitomycin and 5-fluorouracil as anti-scarring agents within the last decade, has greatly improved surgical results of glaucoma filtration surgery. However, a number of problems associated with their use have emerged. At the same time, the transforming growth factor-beta (TGF-b) has been identified as an important component of wound healing, particularly in the conjunctival scarring response. Recent developments in molecular therapy offer exciting prospects for the modulation of wound healing, specifically those targeting TGF-b. As TGF-b is such a potent stimulant of scarring, this review examines its biology and role in ocular wound healing and repair, and discusses promising new approaches to modifying its activity.

Medical Teacher, 1993

Ophthalmoscopy is an essential part of a complete clinical examination of a patient. However spec... more Ophthalmoscopy is an essential part of a complete clinical examination of a patient. However specific formal instruction in fundoscopy is rarely given to medical students. We decided to determine the value of explicit teaching of ophthalmoscopy and devised and validated a rating scale for assessing performance which was used to evaluate 29 first year clinical medical student volunteers at St. Bartholomew's Hospital Medical College, before and after formal instruction in fundoscopy. The competence of this group at ophthalmoscopy was then compared to the rest of their year (109 medical students) during the objective structured clinical end-of-year examination. Students formally instructed in ophthalmoscopy showed an improved score after instruction (from 53% to 77%). They also performed better at fundoscopy than the rest of their year (mean average score 64%), when tested 2 months later, suggesting persistence of the training effect. However as a group they performed no better than their peers at clinical skills other than ophthalmoscopy. We suggest that as fundoscopy is such an important clinical skill, medical students should be given specific teaching, preferably in their ophthalmology firm attachment, as we have shown that it results in a persistent improvement in performance.

American Journal of Ophthalmology, 2011

FINANCIAL DISCLOSURES Dr. Cordeiro has served as a paid consultant and received honoraria for lec... more FINANCIAL DISCLOSURES Dr. Cordeiro has served as a paid consultant and received honoraria for lectures relating to neuroprotection with respect to Allergan (the sponsor of the LoGTS) and several other pharmaceutical companies. She has patents related to diagnostic technologies which may be relevant to assessing neuroprotection, assigned to University College London. Dr Levin has served as a paid consultant and received honoraria for lectures relating to neuroprotection with respect to Allergan (the sponsor of the LoGTS) and several other pharmaceutical companies. He has patents issued or pending on neuroprotective therapies, which are assigned to the Wisconsin Alumni Research Foundation, and a financial interest in a start-up company developing radioprotective drugs. CONTRIBUTION OF AUTHORS Conception and design of editorial, analysis and interpretation of data (MFC, LAL); drafting the article and revising it critically for important intellectual content (MFC, LAL); and final approval of the version to be published (MFC, LAL).

Acta Neuropathologica, 2016