Daniel C. Brănişteanu

University of Medicine and Pharmacy "Grigore T. Popa" Iasi · Ophthalmology

The escalating prevalence of retinal diseases—notably, age-related macular degeneration and hereditary retinal disorders—poses an intimidating challenge to ophthalmic medicine, often culminating in irreversible vision loss. Current treatments are limited and often fail to address the underlying loss of retinal cells. This paper explores the potenti...

Aim: As a medical condition, pregnancy mandates the simultaneous treatment of both the mother and the fetus, making it a distinctive aspect of clinical medicine. Material and Method: We analyze the physiological changes occurring in the eyes and brain during pregnancy, as well as the neuro-ophthalmological manifestations that can occur during pregn...

This investigation aims at evaluating the functional results 1-year following anti-VEGF therapy in macular pathology. Material and method: This is a retrospective examination that was carried out on 57 patients with macular pathology out of 108 at Sf. Spiridon Hospital in Iasi. 57 patients with macular pathology were included in the investigation,...

Glaucoma is a progressive optic neuropathy characterised by retinal ganglion cell degeneration and visual field loss. Glaucoma is considered to be the leading cause of blindness in the industrialised countries. Oxidative damage is an important pathogenic factor in glaucoma, which triggers trabecular meshwork (TM) degeneration, which then leads to i...

The most common disorders of the ocular surface are dry eye disease (DED) and ocular allergy (OA). These conditions are frequently coexisting with or without a clinical overlap and can cause a severe impact on the patient’s quality of life. Therefore, it can sometimes be hard to distinguish between DED and OA because similar changes and manifestati...

(1) Background: Exposure to different sources of stress can have a significant effect on both psychological and physical processes. (2) Methods: The study took place over a period of 34 days and included a total of 40 animals. Regarding the exposure to chronic stressors, we opted for physiological, non-invasive stressors, e.g., running, swimming, a...

Melanoma is a complex and heterogeneous malignant tumor with distinct genetic characteristics and therapeutic challenges in both cutaneous melanoma (CM) and uveal melanoma (UM). This review explores the underlying molecular features and genetic alterations in these melanoma subtypes, highlighting the importance of employing specific model systems t...

The global pandemic impact of the COVID-19 infection included clinical manifestations that affected several organs and systems, with various neuro-ophthalmological manifestations associated with the infection. These are rare and occur either secondary to the presence of the virus or by an autoimmune mechanism secondary to viral antigens. The manife...

Both cutaneous melanoma (CM) and uveal melanoma (UM) represent important causes of morbidity and mortality. In this review, we evaluate the available knowledge on the differences and similarities between cutaneous melanoma and uveal melanoma, focusing on the epidemiological aspects and risk factors. Uveal melanoma is a rare condition but is the mos...

Ehlers–Danlos syndromes (EDS) represent a group of rare inherited disorders that affect connective tissues. There are 13 types of disease, most of them affecting joints or skin; symptoms usually include loose joints, joint pain, stretchy velvety skin, abnormal scar formation. However, the most serious type of disease is vascular EDS (vEDS), or EDS...

The present paper explores genetic polymorphism and its association with thromboembolic retinal venous disorders, such as central/hemi-retinal vein occlusion, as well as possible correlations with other ocular findings, such as closed angle glaucoma, but also with autoimmune general disorders. In this review, we are highlighting the importance of e...

Chronic kidney disease (CKD) is a major public health issue, due to its effect on the quality of life of patients and by the huge costs incurred in treating this disease. It is an irreversible process, characterized by the progressive loss of functional nephrons. CKD ultimately requires the support of renal function by dialysis or even renal transp...

Sentinel lymph node biopsy (SLNB) is a surgical procedure that has been used in patients with cutaneous melanoma for nearly 30 years. It is used for both staging and regional disease control with minimum morbidity, as proven by numerous worldwide prospective studies. It has been incorporated in the recommendations of national and professional guide...

Aim: To construct neural models to predict the progression of glaucoma in patients with sleep apnea. Materials and Methods: Modeling the use of neural networks was performed using the Neurosolutions commercial simulator. The built databases gather information on a group of patients with primitive open-angle glaucoma and normal-tension glaucoma, who...

The main objective of the article was to assess the surgical outcome of micropulse transscleral cyclophotocoagulation in patients presenting with glaucoma after penetrating keratoplasty. We conducted a retrospective study that included 26 eyes of 26 patients who presented with glaucoma after penetrating keratoplasty, and who were treated using micr...

Neovascular glaucoma (NVG) is a refractory form of glaucoma, associated with important morbidity, for which no consensus exists regarding the optimal choice of therapy. The primary aim of our study was to compare the performances of micropulse transscleral cyclophotocoagulation (MP-TSCPC) and continuous wave transscleral cyclophotocoagulation (CW-T...

The ongoing COVID-19 pandemic, declared by the World Health Organisation in March 2020, with the emergence of new, possibly more contagious and more virulent strains, remains a research subject, with the complex systemic involvement better described and understood, but also with a variety of skin and mucosal lesions described in the literature. Muc...

Since the introduction of modern phototherapy in 1903 by Nobel Prize-winner Niels Ryberg Finsen, the usage of this therapy in the medical field has grown, techniques have been refined and developed, and it has gained widespread acceptance. Psoriasis vulgaris, parapsoriasis, lichen planus, atopic dermatitis, neonatal jaundice, urticaria, morphea, vi...

Psoriasis is one of the most common immune-mediated chronic inflammatory skin disorders, involving hyperproliferative keratinocytes and infiltration of T cells, dendritic cells, macrophages, and neutrophils. Multiple factors appear to play important roles in the pathogenesis of psoriasis. These environmental (e.g., infectious agents and trauma), ge...

Psoriasis is a chronic inflammatory and immune-mediated condition, which is no longer considered as being limited to the skin, but may affect the entire body. Epidemiological studies have shown that certain disorders, including obesity, diabetes, liver abnormalities, elevated lipid levels in the blood and metabolic syndrome, may occur more frequent...

Long considered a skin-limited condition, psoriasis is currently defined as a chronic, immune-mediated inflammatory disease, presenting, besides the skin changes, important systemic manifestations, the most common being: psoriatic arthritis, cardiovascular disease, metabolic syndrome, diabetes, inflammatory bowel disease and nonalcoholic steatohepa...

Acne is a chronic inflammatory condition affecting the pilosebaceous unit that was traditionally viewed as a disease of the adolescence. However, over the past several years, an increasing number of adult women have been reported to suffer from this condition. The prevalence of adult female acne ranges between 12 and 54%. Two clinical types can be...

Infectious keratitis is a leading cause of visual morbidity, including blindness, all across the globe, especially in developing countries. Prompt and adequate treatment is mandatory to maintain corneal integrity and to recover the best possible final visual acuity. Although in most of the cases practitioners chose to employ empirical broad-spectru...

The eye is considered an effective target for genetic therapy, as it has a privileged immune status, it is easily accessed for medication delivery and it is affected by a number of inherited disorders. In particular, the retina is considered for gene therapy due to the fact that it can be visualized with ease, it does not have lymphatic vessels, no...

Psoriasis is a common long-lasting, inflammatory disease that mainly affects the skin. The incidence of this condition has increased significantly over time and at this point, it affects approximately 1% of children. Psoriasis can appear at any age, including childhood and adolescence, with a higher frequency in girls, an earlier onset being associ...

Uveal melanoma is a rare condition accounting for only 5% of all primary melanoma cases. Still, it is the most frequently diagnosed primary intraocular malignant tumor in adults. Almost 90% of the tumors involve the choroid and only a small percentage affects the ciliary body or the iris. There is a consistent difference in incidence between differ...

The present paper aims to review the topic of adverse reactions to biological agents, in terms of the incriminating mechanisms and therapeutic approach. As a result of immunomodulatory therapy, the last decade has achieved spectacular results in the targeted treatment of inflammatory, autoimmune, and neoplastic diseases, to name a few. The widespre...

IntroductionThe EyeCOPE study characterized noninfectious intermediate posterior, or panuveitis (NIIPPU) before biologic agents were widely available.Methods This retrospective, observational study included adults with NIIPPU attending a routine ophthalmological visit. Data were collected from the study visit and medical records.ResultsOf 565 patie...

Infectious keratitis represents a serious concern for ophthalmologists, with a progressively growing incidence in the last few years. In this prospective comparative study, we evaluated two groups of patients with infectious keratitis or corneal ulcer resistant to antimicrobial and antifungal therapy, treated respectively with conventional and acce...

The aim of the present study was to carried out a comparative immunohistochemical evaluation of CD117 (c-Kit), a biomarker that evaluates both tumor progression and prognosis, in different melanocytic lesions, to emphasize the significance of this biomarker in malignant melanoma (MM). The study was performed on 55 cases, represented by a control gr...

This report describes a series of cases with massive subretinal hemorrhage (SRH) due to age-related macular degeneration (AMD) treated by subretinal alteplase injections. In all cases, the surgical technique consisted in 25-gauge pars plana vitrectomy (PPV) and alteplase injection under the retina using a 38-gauge cannula. After the fluid-gas excha...

Silicone oil (SIO) has rapidly become an indispensable adjunct in vitreoretinal surgery. Constant improvements in purity and also in viscosity have not totally prevented specific complications that may occur during endotamponade. Results of in vitro studies that suggested that higher viscosity silicone oil might be superior in terms of stability an...

Neovascular age-related macular degeneration (neovascular ARMD) represents only 10% of ARMD cases but is responsible, if untreated, for quick and severe central vision loss due to major macular changes. The presence of choroidal neovascularization (CNV) in one eye is associated with an approximately 10% risk of CNV development in the fellow eye eac...

The coexistence of cataract and vitreoretinal diseases is common in clinical practice. The technological achievements of the last decade in both types of surgeries, allow simultaneous interventions on lens and retina. This retrospective study assessed the morphofunctional results obtained after performing simultaneous surgeries in a series of 87 pa...

Since its introduction in 1959, artificial intelligence technology has evolved rapidly and helped benefit research, industries and medicine. Deep learning, as a process of artificial intelligence (AI) is used in ophthalmology for data analysis, segmentation, automated diagnosis and possible outcome predictions. The association of deep learning and...

Rightfully considered as essential for hydro-electrolytic homeostasis, angiotensin II (Ang II) is the main product of the renin-angiotensin system (RAS). Ang II is one of the most important factors that contribute to the regulation of systemic arterial blood pressure (ABP). This major role is based on the effects exerted by RAS: Upon the kidney (RA...

This review presents a systematic analysis of the literature regarding the pachychoroid disease spectrum nomenclature, diagnosis criteria and therapeutic options. Pachychoroid related diseases are a new concept, introduced into the ophthalmological nomenclature in 2013 and evolving both as concept and as classification since then. The six disorders...

Ocular cicatricial pemphigoid is a particular form of mucous membrane pemphigoid and it is characterized by a chronic bilateral conjunctivitis with relapsing-remitting periods. Without therapy 75% of the cases develop visual loss due to major ocular complications (e.g. severe dry-eye syndrome, corneal erosions, corneal keratinization, entropion, sy...

Literature regarding conjunctival flap surgery was reviewed to describe and discuss the rationale for this type of procedure. The conjunctival flap is an acknowledged surgery for the treatment of various corneal diseases with a chronically compromised ocular surface, such as severe dry eye, neurotrophic or neuroparalytic disease, or bullous keratop...

The skin is an organ with multiple functions, where important inflammatory and immunological processes take place. The integrity of the skin barrier is necessary for it to fulfill its roles. An intact skin barrier requires a physiological keratinization process, but also a normal cutaneous microbial flora. Any change in the proliferation and differ...

Context: State of art imaging techniques might be a useful tool to early detect the retinal vessels lesions in diabetes. Objective and design: This analytical observational study investigates the retinal microcirculation changes in type I and II diabetic patients without retinopathy using adaptive optics ophthalmoscopy (AOO) and optical coherenc...

Abstract. The process of melanin synthesis and distribution is called melanogenesis, a process that is based on melanocytes present among the basal cells of the epidermis. Pigments formed in melanocyte melanosomes are then stored in the basal layer of epidermal cells, as well as in dermal macrophages, which become melanophores. From the embryologic...

Rowell syndrome is defined as the association between lupus erythematosus, erythema multiforme-like lesions and characteristic immunological changes including positive tests for rheumatoid factor, speckled antinuclear antibody, positive anti-Ro or anti-La antibodies. The present report presents the case of a 45-year-old female patient who was previ...

The aim of the report was to evaluate anatomical results and intra and postoperative complications after silicone oil (SIO) removal. Methods Retrospective, interventional study evaluating consecutive cases with ambulatory SIO removal after vitrectomy for complex retinal detachments. The anatomical result was the main followed parameter. Intra and...

Purpose. The assessment of the incidence of ocular hypertension over a period of 1 year in patients treated with multiple intravitreal injections of anti-VEGF agents for neovascular AMD. Methods. The study comprised 58 eyes diagnosed with neovascular age-related macular degeneration and receiving PRN intravitreal treatment with anti-VEGF agents (be...

Terson’s Syndrome is represented by a vitreous, retrohyaloid, retinal, or subretinal hemorrhage occurring consequent to an acute intracranial hemorrhage or elevated intracranial pressure. The outcome may include a complete clearing of the blood and the restoration of VA or persistent hemorrhage. This report presents the case of a 43-year-old woman...

Lichen sclerosus et atrophicus and limited systemic scleroderma (acrosclerosis) are inflammatory skin diseases that ultimately evolve into two distinct modes of atrophic scar formation, but which can easily be confused clinically. They are very rarely associated. The literature has reported cases in which lichen sclerosus was associated with variou...

ETHIOPATOGENIC HYPOTHESES IN LICHEN PLANUS (Abstract): Lichen planus is a mucocutaneous inflammatory dermatosis characterized by a papular rash; the disease is self-limited, has several clinical subtypes and follows a chronic or subacute clinical course. This article presents some etiological hypotheses: stress, genetic predisposition, systemic dis...

Methods: Clinical, morphological, and functional changes were retrospectively evaluated in cases with refractory CNVs to monthly 1.25 mg bevacizumab intravitreal injections (AVASTIN ®) and switched to 3 monthly 2.0 mg intravitreal injections of aflibercept (EYLEA ®). Results: In this pilot evaluation, 8 cases of CNVs that become refractory to in...

Purpose: To assess the anatomical and functional results after vitreoretinal surgery, in a large number of patients with complications due to diabetic retinopathy. Also, to compare the 23G vs. the 20G surgical procedures in these cases, regarding efficacy, facility, safety, and postoperative recovery. Methods: Interventional, retrospective, compara...

Acne fulminans is the most aggressive and destructive form of acne vulgaris, being also known as acne maligna. The onset is acute and systemic involvement is always present. Most commonly, acne fulminans (AF) occurs in male adolescents as a brutal complication of a preexisting mild or moderate acne. The etiology of AF remains incompletely elucidate...

« Off-label » administration of certain drugs has represented a common practice in medicine in the latest decades. Even if this attitude can be sanctioned with full responsibility transfer to the prescribing doctor, there is no law to punish this kind of practice if, from ethical point of view, the main purpose was to offer the best therapeutic opt...

This scientific work summarizes and concludes the efforts of three regional research centers having regard to discovering an innovating topic treatment for the chronic venous disease. New textile biomaterials have been prepared, by chemical or physical application of biopolymers on the textile material, and the load of the biopolymers and biomateri...

Plateau iris is characterized by closing the anterior chamber angle due to a large ciliary body or due to its anterior insertion that alters the position of iris periphery in respect to the trabecular meshwork. There are two aspects that need to be differentiated: plateau iris configuration and plateau iris syndrome. The first describes a situation...

Purpose: To report a case of acute posterior multifocal placoid pigment epitheliopathy (APMPPE), following influenza vaccination. Case report: An 18-year-old female patient developed a painless significant bilateral decrease of vision, moderate photophobia, metamorphopsia and intermittent headaches two weeks after having a seasonal anti-flu immu...

To present the clinical and laboratory features of patients with dermatologic disorders associated with thyroid diseases, diagnostic criteria, type of administered treatment and its effectiveness. This study is a retrospective study based on the medical records of patients with thyroid diseases admitted to the Dermato venereology Clinic of the Iasi...

Psoriasis is a chronic inflammatory disease that can affect up to 1% of children. Genetic (family history of psoriasis) and environmental factors (bacterial or viral infections, stress, and trauma) are frequently involved in its occurrence. Napkin psoriasis is a particular form of psoriasis affecting mainly children younger than 2 years of age and...

Purpose: To assess the anatomical and functional results after intravitreal bevacizumab administration in choroidal neovascularization (CNV) due to angioid streaks; To assess the safety and results stability; Methods: Prospective, nonrandomized, interventional case study on choroidal neovascularization due to angioid streaks treated with intravi...

Unlabelled: Herpes zoster (shingles) is a neurocutaneous viral disease, in recent years its incidence increasing throughout the world. Aim: To study the incidence of herpes zoster among Iasi county patients requiring hospital admission and to analyze the clinical and epidemiological features and socioeconomic status of the study group. Material...

hair in the areas where it normally grows. It has to be distinguished from atrichia, the congenital absence of hair due to the absence of hair follicles, and hipotrichosis, scarcity or absence of hair in some congenital diseases. Alopecia is either scarring, when the skin appears atrophic, scaling, and smooth and the hair follicles are absent, or n...

Subacute lupus erythematosus (SLE) is a specific form of lupus erythematosus characterized by prevalently cutaneous manifestations usually with a good prognosis. It is more common in patients aged 15 to 70 years, and there is a female predilection. This form accounts for 10% of all lupus erythematosus cases. We present the case of a 57-year-old mal...

To reveal the differences in anatomical and functional results following standard 20-gauge vitrectomy and modern transconjunctival sutureless vitrectomy in macular surface pathology. Retrospective, interventional, comparative evaluation of macular pathology cases operated by standard 20-gauge vitrectomy and transconjunctival 23 G sutureless vitrect...

Macular serpiginouschoroiditis is a rare variant of serpiginous choroiditis characterized by a severe recurrent inflammation of both central choroid and retinal pigment epithelium. Visual prognosis is severe due to subsequent distruction of retinal structures. Permanent central visual loss is the consequence of retinal pigment epithelium hyper or h...

Ocular Toxocariasis is a parasitosis caused by Toxocara catis/canis larvae localized in the eye. The most frequent clinical manifestations are the central retinal granuloma, peripheral retinal granuloma and chronic endophthalmitis. Secondary complications due to the presence of parasite in the posterior segment of the eye may have significant conse...

Terminology of persistent diabetic macular edema has been initially reserved to cases unresponsive to conventional laser photocoagulation according to ETDRS criteria. While knowledge about pathophysiology of macular edema evolved and new drugs became available, the terminology of persistent diabetic macular edema expanded to include resistance to m...

To asses the anatomical and functional results after intravitreal bevacizumab administration in choroidal neovascularization secondary to pathologic myopia; To asses the safety and results stability; Prospective, interventional case study of 18 eyes with choroidal neovascularization secondary to pathologic myopia treated with 1.25 mg. intravitreal...

To assess the intra and postoperative difficulties, the anatomical and functional results after intravitreal phacoemulsification during pars plana vitrectomy for retained intraocular lens fragments. Retrospective, non-comparative case series of 48 eyes who underwent vitrectomy for posterior dislocated lens fragments during phacoemulsification betwe...

Purpose: To assess the anatomical result after primary macular hole surgery with or without internal limiting membrane (ILM) peeling. To assess the safety and stability results; Methods: Prospective, comparative, interventional case study of 47 eyes with stage 3 or 4 macular hole treated by pars-plana vitrectomy between 2006 and 2011. In 19 case...

Purpose: To assess the anatomical and visual outcome and also the retinal complications following vitreoretinal surgery for posterior segment intraocular foreign bodies (IOFBs). Methods: Retrospective analysis of 59 IOFBs, with different locations within posterior segment,removed during pars plana vitrectomy (PPV) between January 1999 and Januar...

We present the case of a 29 year old patient, mono-ophthalmic, diagnosed with Acute Retinal Necrosis Syndrome. The disease rapidly progressed despite the medical treatment, and the patient developed complex retinal detachment. After repeated surgical procedures, due to the recurrence of intraocular inflammatory process and the development of a comp...

To compare the benefit of pars plana vitrectomy versus conventional laser therapy in eyes with persistent diabetic macular edema. In this interventional, comparative study we prospectively evaluate 22 eyes from 11 patients with bilateral, persistent diabetic macular edema. In one eye (study eye), at random, pars plana vitrectomy with internal limit...

To evaluate the efficacy and safety of air endo-tamponade in preventing early recurrence of vitreous hemorrhage in diabetic vitrectomy. Prospective, consecutive, interventional, non-randomized study including 40 eyes (from 40 patients) with persistent or recurrent vitreous hemorrhage related to proliferative diabetic retinopathy. At the end of vitr...

Diabetic retinopathy is a major cause of blindness worldwide with an expected increasing incidence. Tight blood sugar and blood pressure control have proven essential in preventing both appearance and evolution of retinopathy. Surgical treatments as laser therapy and vitrectomy have also been proved highly effective in preventing major visual loss...

We describe two comparative series of patients treated with double-dose betaraysbrachytherapy (106 Ruthenium) between 1983 and 1994, and double-dose proton beam therapy between 1991 and 1996. The indications for double-dose irradiation with the same radio-element corresponded to "macroscopically abnormal" situations: immediate and prolonged radiore...

Analysis of the safety and efficiency of various modalities of 5-FU administration in the surgery of refractory glaucoma. A prospective, randomized study including 36 patients with refractory glaucoma who received 5-FU in the following protocols: group A (10 patients)--intraoperative application of 50 mg 5-FU, group B (12 patients)--postoperative s...

Comparing the efficiency and incidence of postoperative complications of classical limited trabeculectomy (30-35 degrees trabecular excision) and large and adapted trabeculectomy (60-120 degrees). A prospective study of 40 patients with symmetric bilateral glaucoma in whom limited trabeculectomy was performed in one eye and large and adapted trabec...

The retrospective analysis of the postoperative course in 204 traumatic cataracts (140 isolated, simple cataracts and 64 aggravated ones) showed an apparent functional improvement in the simple cases (preoperative and postoperative visual acuity 0.0139 and 0.8520, respectively); the incidence of postoperative detachment of retina was of 4.9%, that...

The investigation of 33 patients with late postcontusional glaucoma subjected to surgery and followed up for 25 +/- 8.24 months has revealed: the interval accident-surgery is shorter in the close-angle combined forms; the essential mechanisms responsible for glaucoma occurrence are: the alteration of trabecular meshwork (for open-angle glaucoma) an...