Publications by authors named "Daniela Stana"

9 Publications

  • Page 1 of 1

Association between vascular comorbidity and glaucoma progression: A four-year observational study.

Exp Ther Med 2021 Mar 26;21(3):283. Epub 2021 Jan 26.

Faculty of Medicine, 'Carol Davila' University of Medicine and Pharmacy, 020021 Bucharest, Romania.

Glaucoma, one of the significant causes of blindness worldwide, is a chronic optic neuropathy, characterized by progressive loss of retinal ganglion cells and specific perimetric defects. This study aimed to assess the association between the risk of glaucoma progression and different systemic vascular abnormalities. A 4-year prospective study was carried out on 204 patients diagnosed with open-angle glaucoma. Associated systemic vascular pathology was documented in 102 cases. Progression was encountered in 57 (55.9%) patients with vascular comorbidities and only in 10 (9.8%) patients with no associated vascular diseases (OR 13.81, P<0.01). The vascular risk factors associated with glaucoma progression in the study group were diastolic hypotension (OR 5.444, P=0.027), ischemic cardiac disease (OR 5.826; P<0.01), peripheral vasospasm (OR 3.108, P=0.042) and arterial hypertension (OR 2.593, P=0.05). Diabetes was not significantly correlated with progression in the study group, but only patients without diabetic retinopathy were included. This study highlights that systemic comorbidities associated with endothelial lesions, atherosclerosis and hypoperfusion can lead to damage to the retinal nerve fiber layer and the underlying conjunctive tissue.
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http://dx.doi.org/10.3892/etm.2021.9714DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7851678PMC
March 2021

Diabetic Retinopathy in Patients With Diabetic Foot Ulcer: A Systematic Review.

Int J Low Extrem Wounds 2021 Jun 22;20(2):98-103. Epub 2020 Dec 22.

University of Medicine and Pharmacy "Carol Davila" Bucharest, Bucharest, Romania.

This review discusses the evidence on diabetic retinopathy (DR) in patients with diabetic foot ulceration (DFU). A systematic literature review was performed on PubMed, Medline, Springer Nature, and Scopus, following the PRISMA guidelines, using the following terms, individually or in combination: "diabetic foot ulcer" OR "diabetic foot syndrome" OR "DFU" and "diabetic retinopathy." The initial search yielded 648 articles published between 1975 and 2020. After applying exclusion and inclusion criteria, a total of 9 articles were analyzed, assessing the correlations between DR and DFU. In all cases, DR and especially proliferative diabetic retinopathy were significantly higher in the presence of DFU, though the frequency of DR showed large variability (22.5% to 95.6%). There was a significant correlation between advanced stages of DFU and increased frequency of DR and proliferative diabetic retinopathy. On the other hand, there is a risk of accelerated progression of DR in nonhealing DFUs, possibly related to chronic inflammation and associated infection. Hence, patients with DFUs should be monitored by an ophthalmologist, and those with DR should be promptly referred to a specialized diabetic foot clinic.
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http://dx.doi.org/10.1177/1534734620982237DOI Listing
June 2021

Foveal avascular zone area measurements using OCT angiography in patients with type 2 diabetes mellitus associated with essential hypertension.

Rom J Ophthalmol 2019 Oct-Dec;63(4):354-359

Academic Center for Optical Engineering and Photonics, Politehnica University, Bucharest, Romania.

This study followed the variability in the foveal avascular zone (FAZ) area measured using optical coherence tomography angiography (OCTA) in patients with type 2 diabetes mellitus and high blood pressure. This prospective, non-randomized, cohort study evaluated 46 eyes in 26 patients with high blood pressure associated with diabetic non-proliferative retinopathy (mild, medium, and severe forms) and diabetic proliferative retinopathy. Our results showed early macular alterations (microaneurysms, leakage, neovascularizations, intraretinal microvascular abnormalities), a higher class of severity despite a relatively normal clinical aspect and higher values of FAZ associated with neovascularization undetected by SD-OCT (spectral domain-OCT). Measurement of the foveal avascular zone area using OCTA early detects macular alterations that precede classical retinography and SD-OCT determinations. FAZ = foveal avascular zone; OCTA = optical coherence tomography angiography; IRMA = intraretinal microvascular abnormalities; SD-OCT = spectral domain-optical coherence tomography; OU = both eyes; PD = papillary diameter; ETDRS = early treatment diabetic retinopathy study; BP = blood pressure; OD = right eye.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6943282PMC
March 2020

Variability of diabetic macular edema in correlation with hypertension retinopathy in patients with diabetes mellitus and essential hypertension.

Rom J Ophthalmol 2019 Oct-Dec;63(4):327-338

Academic Center for Optical Engineering and Photonics, Politehnica University, Bucharest, Romania.

This study aimed to determine the possible relationship between variability of diabetic macular edema associated with hypertension retinopathy in patients with type 2 diabetes mellitus and essential high blood pressure, in correlation with contrast sensitivity. In order to accomplish the objective, this retrospective study evaluated the progression of diabetic macular edema in patients with high blood pressure during day time through measurements of the total macular volume and central macular thickness using optical coherence tomography and contrast sensitivity variations measured through Pelli Robson test, four times a day, along with glycemia and blood pressure measurements. Our results showed a statistically significant correlation between the values of glycemia and central macular thickness, and between contrast sensitivity and macular thickness at every tested hour. The study revealed many statistically significant correlations involving blood pressure, blood glucose levels, Pelli Robson test and central macular thickness. OCT = optical coherence tomography; DME = diabetic macula edema; SD-OCT = spectral domain optical coherence tomography; LOCS = lens opacities classification system; LE = left eye; ANOVA = analysis of variance.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6943295PMC
March 2020

Fulminant bilateral acute retinal necrosis after chickenpox - a case report.

Rom J Ophthalmol 2016 Jul-Sep;60(3):184-187

"Carol Davila" University of Medicine and Pharmacy, Bucharest.

We present the case of a 34-year-old male, admitted for progressive bilateral loss of vision after a recent episode of chickenpox. Ophthalmological exam revealed bilateral acute retinal necrosis. As the patient was following a drug detoxification program, he was tested for HIV, HVB, HVC, and results highly positive. Immediate intravenous therapy with high doses of acyclovir and methylprednisolone was initiated, but the evolution was extremely severe resulting in necrotic retinal detachment. Surgery was performed in right eye, but no improvement of visual acuity was observed.

Conclusions: The fulminant evolution of bilateral acute retinal necrosis and the lack of response to maximal intravenous therapy were clinical elements indicating coexistent immunosuppressive disease. Very severe acute retinal necrosis may occur in immunosuppressed patients, leading to blindness.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5720133PMC
May 2018

[Different significance in normal subjects and in glaucoma patients tested with Optopol PTS-910, in the galucoma program].

Oftalmologia 2013 ;57(1):33-9

Universitatea de Medicină şi Farmacie Carol Davila Bucureşti.

Purpose: to quantify the inter-test variability (dB) for the Optopol PTS automated perimeter, Glaucoma Fast threshold program.

Materials And Method: A prospective study was performed on 166 glaucomatous patients and a control group of 30 normal subjects, tested by complete ophthalmological exam and automated perimetry (Optopol PTS-910). The visual field was tested weekly for 4 consecutive weeks. The visual field defects were classified according to the Aulhorn-Karmeyer descriptive scale.

Results: For the control group, the medium inter-test variability was of 1.57 +/- 0.24 dB, lower next to fixation and increasing towards the 50 degree isopter. The medium inter-test variability increases along with the perimetric stage :1.57 +/- 0.66 dB for pre-perimetric glaucoma, 2.13 + 1.04 dB for non-specific defects group, 3.23 + 1.01 dB for the stage 1, 3.52 + 2.61 dB, for the stage 2, 3.65 + 1.19dB for the stage 3 and 5.82 +/- 1.67dB for the stage 4. For the cases of preperimetric glaucoma and non-specific defects, a similar profile of variability to the normal subjects can be observed. For the stages 2-4, the profile of the areas with maxim inter-test variability moves towards the relative scotoma and the surrounding area.

Conclusions: A better description of the inter-test variability and the evolution of this intricate parameter of the retinal light sensitivity is useful for the differential diagnostic between the real change and the "background noise" in early detection of the functional progression in glaucoma.
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January 2014

[Structure-function correlation in early diagnosis of glaucoma progression].

Oftalmologia 2011 ;55(4):111-6

Universitatea de Medicină şi Farmacie "Carol Davila" Bucureşti.

Purpose: The study investigates the correlations between structure and function in early detection of glaucoma progression.

Materials And Method: A prospective study was carried on 204 patients diagnosed with POAG and a follow-up period of 4 years. All the patients underwent complex ophthalmological examination, C/D ratio, Disk Damage Likelyhood Scale (DDLS), automated perimetry and Heidelberg retina tomography

Results: The relations between structure and function were investigated for all patients, but also according to clinical stage of glaucomatous damage. Structural progression was more frequently associated with perimetric progression for patients with moderate advanced glaucoma. For patients with preperimetric glaucoma and early glaucoma, the progression was present more often for structural test (19,04% and 29,3%), while perimetric progression was less frequent objectivated and weak correlated with structural progression (16,66%). For the 15 cases diagosed with both structural and functional progression, the locations of the structural lesion and functional defect were better correlated in cases involving the poles of the optic disc.

Conclusions: Structure-function relation depends on clinical stage of glaucoma and the location of the glaucomatous defects. In early stages, structural investigations can detect progression before perimetry, while in advanced stages, the functional tests are more useful for early detection of progression.
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July 2012

[Purtscher retinopathy--case report].

Oftalmologia 2009 ;53(2):44-7

Spitalul Universitar de Urgenta Bucuresti.

The authors present the case of a 27 years old man who came to our clinic for sudden, painless and profound bilateral loss of visual acuity in both eyes, 14 days ago, during hospitalization for an acute episode of abdominal pain. The clinical aspect correlated with the personal pathological aspects permitted us to establish the diagnosis of Purtscher retinopathy.
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September 2009

[Primary antiphospholipid syndrome].

Oftalmologia 2008 ;52(1):13-7

Spitalul Universitar De Urgenta Bucuresti, Clinica Oftalmologie.

Antiphospholipid syndrome (APS) is a disorder characterised by recurrent arterial or venous thrombosis and/or pregnancy losses, in the presence of persistently elevated levels of anticardiolipin antibodies and/or evidence of circulating lupus anticoagulant (these abnormalities are detected by blood tests). Primary APS occurs when there is no evidence of associated diseases. APS in the presence of an underlying disease, usually systemic lupus erythematosus, is called secondary APS.
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December 2008