Eduardo M Normando's research while affiliated with Imperial College Healthcare NHS Trust and other places

Publications (68)

Article
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Purpose To evaluate novel ‘Rose Plot Analysis’ (RPA) in the analysis and presentation of glaucoma structural progression data. Design A case-control image analysis study using retrospective retinal imaging series Subjects Subjects with open-angle glaucoma, with at least five registered spectral-domain optical coherence tomography (SD-OCT) scans....
Article
Purpose COVID-19 has greatly affected the number of patients willing and able to attend hospital, with research activity also greatly impacted. Imperial College Ophthalmology Research Group (ICORG) have observed clinical backlogs and a 77% decrease in trial patient recruitment. As a first of its kind, this project aims to combat clinic waiting list...
Article
Purpose To determine the impact of delayed follow-up on the disease course in patients with glaucoma. Methods A retrospective case series of 224 glaucoma patients. Data analysis from the hospital electronic medical record was performed on patients attending the glaucoma clinic between April and May 2021 at Charing Cross Hospital, London, United Ki...
Article
Purpose To evaluate glaucoma rose plot analysis (RPA), a novel display of circumpapillary optical coherence tomography (OCT) progression data. Methods A novel RPA protocol was developed to automatically analyse and display progression analysis of circumpapillary retinal nerve fibre layer (cRNFL) OCT data. A clustering technique was employed to all...
Article
Purpose Assessment of cross-linked sodium hyaluronate (XLHA) in improving circumpapillary OCT scan quality and segmentation accuracy Methods Circumpapillary OCT scans (Heidelberg Spectralis) of prospectively recruited glaucoma clinic patients were assessed. Patients were included if suboptimal image quality was suspected, based on live preview ima...
Article
Background Due to an aging population, the demand for many services is exceeding the capacity of the clinical workforce. As a result, staff are facing a crisis of burnout from being pressured to deliver high-volume workloads, driving increasing costs for providers. Artificial intelligence (AI), in the form of conversational agents, presents a possi...
Preprint
BACKGROUND Due to an aging population, the demand for many services is exceeding the capacity of the clinical workforce. As a result, staff are facing a crisis of burnout from being pressured to deliver high-volume workloads, driving increasing costs for providers. Artificial intelligence (AI), in the form of conversational agents, presents a possi...
Article
Introduction: Retinal imaging is a key investigation in ophthalmology. New devices continue to be created to keep up with the demand for better imaging modalities in this field. This review looks to highlight current trends and the future of retinal imaging. Areas covered: This review looks at the advances in topographical imaging, photoacoustic...
Article
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PurposeThis study evaluates the 6-month safety and efficacy of micropulse transscleral cyclophotocoagulation (MP-TSCPC) in cases of uncontrolled glaucoma/ocular hypertension using a reduced energy protocol.Methods Retrospective analysis of patients undergoing MP-TSCPC from January–April 2018 was carried out. Patients received up to 90 s of laser wi...
Article
Background: A key objective in glaucoma is to identify those at risk of rapid progression and blindness. Recently, a novel first-in-man method for visualising apoptotic retinal cells called DARC (Detection-of-Apoptosing-Retinal-Cells) was reported. The aim was to develop an automatic CNN-aided method of DARC spot detection to enable prediction of...
Chapter
Neuro-ophthalmology is the branch of ophthalmology dedicated to the study of neurological conditions which affect the visual system. An adequate understanding of the aetiology and pathophysiology of neuro-ophthalmic conditions is fundamental for establishing successful therapeutic strategies. Animal models are therefore considered crucial for under...
Article
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Introduction: People with Down's syndrome (DS) have a high prevalence of early-onset Alzheimer's disease. Early markers of Alzheimer's disease pathology identifiable before clinical change are needed for the evaluation of preventative treatments. The retina, an extension of the brain, may provide a noninvasive imaging site. Methods: Forty-nine a...
Article
Purpose To quantify the proportion of diabetic patients undergoing pancreas transplant in West London and their service use. To characterise their long‐ and short‐term retinopathy grading and visual function outcomes following surgery, the incidence of ophthalmic interventions and factors associated with DR progression. Methods Retrospective study...
Article
Purpose To investigate the role of longitudinal analysis of macular Optical Coherence Tomography (OCT) scans in identification of glaucoma progression. Methods 40 eyes of 20 patients diagnosed with glaucoma were retrospectively assessed over a period of 3 years with visits intervals of 4–6 months. Data were acquired at each time point with Posteri...
Article
The role of OCT macula scans in glaucoma has been extensively investigated. However, to date, only subjective and qualitative analyses can be performed for macula scans in glaucoma. We propose a novel method to objectively assess glaucoma progression based on the Longitudinal Analysis of the Poster Pole (LaPo). Forty eyes were assessed over 3 years...
Article
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Glaucoma is one of the leading causes of irreversible blindness in the world. It is characterized by the progressive loss of retinal ganglion cells (RGCs), mainly through the process of apoptosis. Glaucoma patients often come to clinical attention when irreversible loss of visual function has been already established; therefore, early recognition o...
Article
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Introduction: Increasing life expectancy and ageing populations across the world are causing the number of glaucoma patients to rise dramatically. With longer lifespans also comes the need to improve the timeframe and accuracy with which we can diagnose, monitor and treat patients, ensuring longevity of vision contributes to a meaningful quality of...
Article
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Glaucoma is one of the leading causes of irreversible visual loss, which has been estimated to affect 3.5% of those over 40 years old and projected to affect a total of 112 million people by 2040. Such a dramatic increase in affected patients demonstrates the need for continual improvement in the way we diagnose and treat this condition. Annexin A5...
Article
Neurodegenerative disorders such as Alzheimer Disease, Parkinson Disease and Multiple Sclerosis present ocular manifestations which could precede general signs and symptoms. This correlation between the eye and the brain has been confirmed by recent advances in imaging technologies. Hardware and software improvements have given the possibility of e...
Article
Purpose Glaucoma diagnosis and follow up of progression is often based on structural and functional assessments. This study aimed to assess clustered progression in comparison to global indices and structural measures from HRT and OCT. Methods 16 eyes of OHT and glaucoma patients with a minimum of 5 visual fields (HFA II i 24‐2) over a year were a...
Article
Coenzyme Q10 (CoQ10) is a mitochondrial-targeted antioxidant with known neuroprotective activity. Its ocular effects when co-solubilised with α-tocopherol polyethylene glycol succinate (TPGS) were evaluated. In vitro studies confirmed that CoQ10 was significantly protective in different retinal ganglion cell (RGC) models. In vivo studies in Adult D...
Article
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See Herms and Schön (doi:10.1093/brain/awx100) for a scientific commentary on this article. Retinal cell apoptosis occurs in many ocular neurodegenerative conditions including glaucoma—the major cause of irreversible blindness worldwide. Using a new imaging technique that we have called DARC (detection of apoptosing retinal cells), which until now...
Article
Full-text available
The amyloid beta (Aβ) pathway is strongly implicated in neurodegenerative conditions such as Alzheimer’s disease and more recently, glaucoma. Here, we identify the α2 adrenergic receptor agonists (α2ARA) used to lower intraocular pressure can prevent retinal ganglion cell (RGC) death via the non-amyloidogenic Aβ-pathway. Neuroprotective effects wer...
Presentation
The purpose of this study is to investigate degeneration and apoptosis of retinal cells in people with Down's syndrome (DS) and the relationship with aging. People with DS have a high risk of developing early-onset Alzheimer's disease (AD) with an increasing age-related prevalence. Spectral-domain optical coherence tomography (SD-OCT) was used to i...
Article
Alzheimer's (AD) and Parkinson's disease (PD) are the most common cause of dementia characterized by progressive deterioration in cognitive function. These neurodegenerative disorders present ocular manifestations which could precede systemic signs and symptoms of disease. Correlations between the eye and the brain have been confirmed by recent adv...
Conference Paper
Purpose Although it is well-documented that many patients with Parkinson's disease (PD) present with visual disabilities, scientific research has largely neglected the relation between PD and retinal dysfunction. A profound understanding of the retinal manifestations of PD, however, would not only help to gain new insights into its pathogenesis, it...
Article
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Parkinson’s Disease (PD) is the second most common neurodegenerative disease worldwide, affecting 1 % of the population over 65 years of age. Dopaminergic cell death in the substantia nigra and accumulation of Lewy bodies are the defining neuropathological hallmarks of the disease. Neuronal death and dysfunction have been reported in other central...
Article
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Secondary neurodegeneration is thought to play an important role in the pathology of neurodegenerative disease, which potential therapies may target. However, the quantitative assessment of the degree of secondary neurodegeneration is difficult. The present study describes a novel algorithm from which estimates of primary and secondary degeneration...
Chapter
Neuro-ophthalmology is the branch of ophthalmology dedicated to the study of neurological conditions which affect the visual system. An adequate understanding of the aetiology and pathophysiology of neuro-ophthalmic conditions is fundamental for establishing successful therapeutic strategies. Animal models are therefore considered crucial for under...
Article
Full-text available
Objective: In a previous study, we reported the upregulation of Nerve Growth Factor (NGF) and trkANGFR expression in Ocular Cicatricial Pemphigoid (OCP), an inflammatory and remodeling eye disease. Herein, we hypothesize a potential NGF-driven mechanism on fibroblasts (FBs) during OCP remodeling events. To verify, human derived OCP-FBs were isolat...
Article
Due to their accessibility, animal models are playing a major role in understanding some of the underlying causes of glaucoma. Optical Coherence Tomography (OCT) has been used extensively in these animal models giving us the advantage of longitudinal in-vivo assessments of the natural history of this disease. Outer retina involvement has recently b...
Article
Glaucoma is one of the leading causes of blindness worldwide and will affect 79.6 million people worldwide by 2020. It is caused by the progressive loss of retinal ganglion cells (RGCs), predominantly via apoptosis, within the retinal nerve fibre layer and the corresponding loss of axons of the optic nerve head. One of its most devastating features...
Article
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Irreversible damage to the optic nerve can follow the rapid increase of IOP during an acute primary angle closure (APAC). Despite the development of advanced imaging technology, there is still a lack of good longitudinal studies assessing patients after an acute attack. The aim of this study was to assess the progression of patients using different...
Article
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Retinal cell apoptosisRetinal cell apoptosis occurs in many eyeeye conditions, including glaucomaglaucoma , diabetic retinopathy and Alzheimer's disease. Real-time detectionReal-time detection of retinal cell apoptosisapoptosis has potential clinical value in early disease detection, as well as evaluating disease progression and treatment efficacy....
Article
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Cell-based therapies are increasingly recognized as a potential strategy to treat retinal neurodegenerative disease. Their administration, however, is normally indirect and complex, often with an inability to assess in real time their effects on cell death and their migration/integration into the host retina. In the present study, using a partial o...
Article
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Background Retinal ganglion cell (RGC) loss is one of the earliest and most important cellular changes in glaucoma. The DARC (Detection of Apoptosing Retinal Cells) technology enables in vivo real-time non-invasive imaging of single apoptosing retinal cells in animal models of glaucoma and Alzheimer’s disease. To date, apoptosing RGCs imaged using...
Article
Effective delivery to the retina is presently one of the most challenging areas in drug development in ophthalmology, due to anatomical barriers preventing entry of therapeutic substances. Intraocular injection is presently the only route of administration for large protein therapeutics, including the anti-Vascular Endothelial Growth Factors Lucent...
Article
To assess the expression of toll-like receptors (TLRs) in human amniotic membrane (AM) specimens and compare this expression with those of AMs undergoing the standard preservation procedure (handling) for ocular surgery. Human fresh (n = 10; five spontaneous and five cesarean) or handled (n = 5) AMs were analyzed for TLR gene and protein expression...
Article
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Dimethyl sulfoxide (DMSO) is an important aprotic solvent that can solubilize a wide variety of otherwise poorly soluble polar and nonpolar molecules. This, coupled with its apparent low toxicity at concentrations <10%, has led to its ubiquitous use and widespread application. Here, we demonstrate that DMSO induces retinal apoptosis in vivo at low...
Article
Since the discovery of fluorescein angiography much progress has been made in the field of retinal imaging. For age-related macular degeneration in particular, the scientific and clinical communities are facing a revolution in diagnostic tools. Confocal scanning laser ophthalmoscopy and spectral domain optical coherence tomography have enabled the...
Article
Glaucoma is one of the leading causes of blindness in developed countries and is mainly attributable to the apoptosis of retinal ganglion cells (RGCs). Although several diagnostic tools have been developed to detect and monitor this disease, none has the requisite sensitivity to identify it at a preclinical stage or to perceive small changes in ret...
Article
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Neuropilin 1 (NRP1) is a transmembrane glycoprotein that is essential for blood vessel development in vertebrates. Best known for its ability to bind members of the vascular endothelial growth factor (VEGF) and class 3 semaphorin families through its extracellular domain, it also has a highly conserved cytoplasmic domain, which terminates in a SEA...
Article
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Involvement of the outer retina is controversial in glaucoma. The aim of this study was to test, first, whether the outer retina is affected in experimental ocular hypertension (OHT) and, second, whether whole retinal thickness can be used as a surrogate marker of glaucomatous change. OHT was surgically induced in 20 Dark Agouti rats. Animals were...
Article
To evaluate near-infrared (NIR) autofluorescence (AF) in patients with geographic atrophy (GA) secondary to age-related macular degeneration and to investigate the origin of the signal by in vivo and histological analysis in rats and in a human donor eye. Confocal scanning laser ophthalmoscopy in vivo imaging, including blue (excitation: 488 nm, em...
Article
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Nerve cell death is the key event in all neurodegenerative disorders, with apoptosis and necrosis being central to both acute and chronic degenerative processes. However, until now, it has not been possible to study these dynamically and in real time. In this study, we use spectrally distinct, well-recognised fluorescent cell death markers to enabl...
Article
Retinal ganglion cell apoptosis has long been highlighted as an important early event in glaucoma. Recent work from our group has shown that it is possible to visualise its occurrence in vivo using detection of apoptosing retinal cells (DARC), a recently devised non-invasive realtime imaging technique using fluorescently labelled annexin V and opht...
Article
Full-text available
To investigate if nerve growth factor (NGF) might modulate toll-like receptor (TLR) 4 and 9 expression in primary cultures of vernal keratoconjunctivitis (VKC)-derived conjunctival epithelial cells (VKC-ECs). Primary cultures of ECs were established from VKC (n=7) and healthy-control (n=5) conjunctival specimens. Primary untouched and short-term NG...
Article
Recent studies suggest that natural killer (NK) cells exert effector/regulatory properties on both innate and adaptive responses via release of different cytokines. While some information indicates NK cells in allergic asthma and atopic dermatitis, no data are available for allergic conjunctivitis. The aim of this study was to evaluate NK in the bl...
Article
Full-text available
To evaluate the role of nerve growth factor (NGF) in remodeling processes of vernal keratoconjunctivitis (VKC). VKC is a chronic inflammatory disorder of the conjunctiva and is characterized by marked tissue remodeling. NGF, a pleiotrophic factor with documented profibrogenic activities, is produced by inflammatory and structural cells populating t...

Citations

... The rapid development of fundus imaging technology has led to an increasing range of fundus images, with more accurate picture resolution, non-invasive examination methods, and efficient treatment (54). The range of visual fundus imaging has evolved from 25°to 35°, 45°, and 55°in the early days, and the most remarkable progress has been made with the advent of laser ophthalmoscopy, which has enabled a qualitative leap in the range of fundus imaging, from 55°to over 100°. ...
... In the ICU, AI may assist clinicians on diagnostic, prognostic, and curative levels to revamp patient outcomes. Currently, it has been used in detecting therapeutic tubes and catheters [4,5], Deep learning, a form of AI, is being increasingly employed in the processing of medical images of the eyes, brain, breast, chest, musculoskeletal system, pelvis, and abdomen [6,7]. Deep learning could automate the detection of thoracic disorder in CXR [8]. ...
... Further, four eyes (6.7%) and one eye (1.7%) gained satisfying IOP lowering after two and three sessions of MP-TSCPC, respectively. The previously reported rate of treatment success of MP-TSCPC was variable, ranging from 35% to 95.7% over a mean follow-up of 6 to 18 months [25][26][27][28]30,39,[42][43][44][45][46][47]. Our rates of success were comparable with other published reports on MP-TSCPC, despite the lower total energy of the laser we employed. ...
... As a potential early biomarker for AD, retinal thinning has been investigated in DS. In contrast to what has been observed in sAD or mild cognitive impairment (MCI), the retina was found to be thicker in those with DS compared to age-matched controls 9 despite the AD pathology and the accelerated aging effect in DS. 2,10 In sAD, the choroid also undergoes thinning, both in MCI 11 and later stages, 12,13 as assessed in vivo using enhanced depth imaging optical coherence tomography (EDI-OCT). It is believed that Aβ accumulation in the choroid leads to inflammation, which results in neurodegeneration and vascular attenuation, mirroring the evolution of the amyloid cascade in the brain. ...
... Biologically, the 'bottom-up theory' and the 'top-down theory' could provide plausible explanations. The 'bottom-up theory' postulated that impairment of the retinal dopaminergic system might explain VI in PD [27]. Both animal and clinical studies had suggested that dopaminergic retinal cell loss was commonly seen in PD [28À31]. ...