Photodiagnosis and photodynamic therapy最新文献

Objective: This study aims to investigate the variations in anterior segment parameters among patients with different degrees of myopia and explore their impact on myopia progression.

Methods: A retrospective analysis was conducted on ocular parameters of 4,392 patients who underwent myopia correction surgery at the affiliated hospital of Southwest Medical University from January 2019 to January 2023. The patients were categorized into mild, moderate, and high myopia groups based on the severity of their myopia. Measurements of corneal thickness (CCT), intraocular pressure (IOP), axial length (AL), steep corneal curvature (Ks), flat corneal curvature (Kf), white-to-white corneal diameter (WTW), pupil diameter under bright conditions (LPD), pupil diameter under dark-adapted conditions (DPD), corneal volume (CV), anterior chamber volume (ACV), anterior chamber depth (ACD), and Kappa angle values (Kx and Ky) were performed and analyzed using SPSS 28.0 software.

Results: Significant differences were observed in most of the aforementioned parameters among patients with different degrees of myopia. With increasing myopia severity, CCT, IOP, AL, Ks, Kf, CV, ACV, ACD, and Ky exhibited a gradual increase (all P<0.05), while WTW and DPD showed a gradual decrease (all P<0.05). Kx and LPD did not exhibit statistically significant differences (P>0.05). Correlation analysis revealed significant positive correlations between IOP and the degree of myopia (OR=1.02, P=0.005), WTW and the degree of myopia (OR=0.47, P<0.001), ACV and the degree of myopia (OR=1.01, P<0.001), and significant negative correlations between ACD and the degree of myopia (OR=0.83, P=0.031). Ky showed a significant positive correlation with the degree of myopia (OR=2.55, P<0.001). These findings provide further evidence of the association between ocular parameters and myopia progression.

Objective: This study aimed to quantitatively examine choroidal structural alterations in patients with type 2 diabetes mellitus (T2DM) of varying disease duration who did not present with clinical diabetic retinopathy (DR), using ultra-widefield swept-source optical coherence tomography angiography (UWF-SS-OCTA).

Methods: This cross-sectional study included 200 patients with T2DM without DR (200 eyes) and 78 healthy individuals (78 eyes). Based on diabetes duration, patients were categorized into three groups: less than 5 years (DM1, n = 80), 5 to 10 years (DM2, n = 60), and more than 10 years (DM3, n = 60). UWF-SS-OCTA was used to quantify choroidal thickness (CT), choroidal vascular volume (CVV), and choroidal vascularity index (CVI) in the peripapillary region, the macula-centered UWF central area (1-12 mm), and the peripheral area (12-21 mm). One-way analysis of variance with post hoc testing assessed intergroup differences. Multivariable linear regression was performed to evaluate the associations between diabetes duration and choroidal parameters.

Results: Relative to healthy controls, patients in the DM3 group exhibited significant reductions in CT and CVV in all evaluated regions, along with decreases in CVI in most regions (all p < 0.05). When diabetic subgroups were compared, the DM3 group demonstrated significantly lower CT and CVV across all regions compared with the DM1 and DM2 groups (all p < 0.05). Central CVI showed a progressive decline with longer diabetes duration, while peripheral CVI differed significantly only between the DM3 and DM1 groups. Except for peripheral CVI, CT, CVV, and central CVI across all assessed regions were independently and negatively associated with diabetes duration (all p < 0.05).

Conclusion: Patients with T2DM without DR demonstrated early choroidal thinning and vascular deterioration, which progressively worsened with longer diabetes duration. UWF-SS-OCTA revealed that the choroidal alterations in T2DM without DR were widespread but most pronounced in the peripheral regions, highlighting the importance of wide-field imaging for comprehensive assessment.

Significance: Perifolliculitis capitis abscedens et suffodiens (PCAS) is a chronic, refractory, and recurrent inflammatory disorder of the scalp that severely affects patients' quality of life and appearance. Despite various available treatments, no optimal therapeutic strategy has been established. Compared to conventional therapies, 5-aminolevulinic acid photodynamic therapy (ALA-PDT) demonstrates favorable efficacy and tolerability. Pretreatment before photodynamic therapy plays a crucial role in optimizing therapeutic outcomes. This study evaluated the efficacy of ALA-PDT combined with intracavitary triamcinolone lavage in the management of PCAS.

Approach: Four patients with PCAS were treated using ALA-PDT following intracavitary triamcinolone lavage pretreatment. Therapeutic efficacy was assessed by comparing symptom improvement before and after treatment.

Results: All four patients achieved significant clinical improvement and exhibited good treatment tolerance, with no serious adverse reactions observed. During a minimum follow-up period of 6 months, no disease recurrence was detected in any of the patients.

Conclusions: ALA-PDT combined with intracavitary triamcinolone lavage pretreatment appears to be a safe and effective therapeutic option for PCAS. This combined approach may offer enhanced clinical outcomes compared with monotherapy, although treatment parameters should be individualized according to each patient's condition.

Objective: This study aimed to evaluate the analgesic effect of photodynamic therapy (PDT) on post-endodontic pain (PEP) in paediatric patients after pulpectomy under dental general anaesthesia (DGA) compared to conventional treatment.

Methods: A double-blind, randomised, parallel-controlled clinical trial included 60 paediatric patients aged 3-6 years who required pulpectomy in deciduous teeth under DGA. Pulpectomy followed a standard endodontic protocol. Participants were randomly allocated to two groups. The experimental group received PDT with 1% methylene blue, and the control group received a sham laser with sterile saline. The primary outcome was PEP intensity, assessed using the visual analogue scale at 6, 12, 24, 48, and 72 h and 1 week postoperatively. Secondary outcomes included analgesic use. Data were analysed using generalised estimating equations (GEEs) and non-parametric tests.

Results: Baseline characteristics were similar between groups. Pain scores were significantly lower in the PDT group than in the control group at 6, 12, 24, 48, and 72 h (P < 0.05) but not at 1 week (P > 0.05). GEEs analysis revealed significant main effects of time (Wald χ² = 108.873, P < 0.001) and group (Wald χ² = 29.833, P < 0.001), with a significant group-by-time interaction (Wald χ² = 36.965, P < 0.001). Analgesic use showed a non-significant reduction in the PDT group (P = 0.424).

Conclusion: Endodontic therapy assisted with PDT effectively reduced PEP in paediatric patients under DGA, particularly within the first 72 h, offering a safe and beneficial adjunct for early postoperative comfort.

Purpose: To describe and investigate the associations between different glucose-lowering management and diabetic retinopathy (DR).

Methods: Our study was a cross-sectional analysis. By comparing different glucose-lowering management methods, we aim to explore their impact on the occurrence of diabetic retinopathy (DR) and their influence on its severity. Logistic regression models were used to estimate the odds ratio (OR).

Results: Through the Beichen Eye Study (BCES), 844 patients were included in the cross-sectional analysis. The prevalence of DR was 19.30% among patients on oral hypoglycemic agents (OHA), 50.00% on insulin treatment, and 37.12% among those on combined use, giving an overall frequency of 24.65%. No statistically significant differences were observed among different types of oral hypoglycemic agents on the incidence and severity of DR. Logistic regression showed insulin therapy was associated with the prevalence of DR [insulin: OR= 3.57 (95% CI: 1.16 ∼ 11.05), p= 0.027; combination: OR= 2.01 (95% CI: 1.39 ∼ 2.91), p< 0.001].

Conclusion: Compared with OHA, either increasing insulin therapy or using insulin alone can be a risk factor for DR, yet it has no impact on DR severity.

Objective: This systematic review and meta-analysis examined the adjunctive effect of indocyanine green-mediated antimicrobial photodynamic therapy (ICG-aPDT) with scaling and root planing (SRP) in periodontitis to address limited and inconsistent evidence regarding its clinical and microbiological efficacy.

Data sources: Electronic searches were conducted in MEDLINE (via PubMed), Scopus, Web of Science, Embase, Cochrane Library, ProQuest, and Google Scholar up to March 2025.

Study selection: Controlled clinical trials comparing SRP+ICG-aPDT with SRP alone were included. Primary outcomes were PPD and CAL; secondary outcomes were plaque, gingival, and bleeding indices, and subgingival microbial load. Risk of bias followed the Cochrane Handbook, and random-effects meta-analyses with subgroup analyses were performed.

Results: Sixteen studies involving 541 participants were included. Adjunctive ICG-aPDT led to additional mean reductions in PPD (-1.05, -0.86, and -0.84 mm at 1, 3, and 6 months; all p<0.001) and gains in CAL (-0.59 and -0.80 at 3, and 6 months; both p<0.001) compared with SRP alone. Plaque and gingival indices improved significantly at 3 months (SMD=-0.83 and -1.05; both p<0.001), and 6 months (SMD=-1.13 and -1.07; p<0.001 and p=0.02, respectively). Bleeding index showed marked reductions at both 3 and 6 months (SMD=-1.32 and -1.76; both p<0.001). The subgingival P. gingivalis load also decreased significantly (SMD=-0.33; p=0.04). Subgroup analyses showed no significant differences by irradiation type or session number (all p>0.05).

Conclusions: Adjunctive ICG-aPDT showed statistically significant but clinically modest improvements in periodontal outcomes, with PPD effects close to a 1-mm interpretive benchmark; however, high heterogeneity and methodological limitations warrant cautious interpretation and further standardized trials.

Purpose: To investigate whether low-level LED red-light therapy promotes axial elongation in hyperopic children.

Methods: This bidirectional cohort study included 201 hyperopic children aged 4 -13 years. Participants were divided into two groups: the LED group (n = 51), who received low-level LED red-light therapy, and the spectacle-only comparison group (n = 150). Axial length (AL) was measured at baseline and each follow-up. Longitudinal changes in AL were analyzed using a linear mixed-effects model (LMM). Inverse probability of treatment weighting (IPTW) was performed as a sensitivity analysis to minimize potential confounding. In a subgroup of 40 anisometropic children who received unilateral LED treatment, interocular comparisons between treated and fellow eyes were conducted using paired t-tests, and within-subject LMM analyses to assess eye-specific treatment effects.

Results: The LED group showed a significantly faster rate of axial elongation than the comparison group (interaction β=+0.082 mm/year, 95% CI: 0.042 to 0.122; p < 0.001). In the anisometropic subgroup, treated eyes elongated significantly faster than fellow eyes (mean difference = +0.167 mm/year, 95% CI: 0.109-0.226; p < 0.001), leading to a reduction in interocular axial length disparity. LMM confirmed a greater time-dependent increase in treated eyes (β = +0.151 mm/year, 95% CI: 0.102-0.199; p < 0.001).

Conclusions: Low-level LED red-light therapy significantly accelerates axial elongation in hyperopic children and reduces interocular differences in anisometropic cases, suggesting that it may promote more balanced binocular refractive development.

Background: Cutaneous leishmaniasis (CL) is a parasitic skin disease caused by Leishmania spp., transmitted through infected sandflies. It manifests with lesions ranging from self-healing papules to chronic ulcerative plaques, depending on the parasite species and host immunity. Current treatments, including systemic antimonials, amphotericin B, miltefosine, and intralesional injections, are limited by systemic toxicity, invasiveness, and prolonged regimens, with additional challenges in children due to pain and poor compliance.

Objective: To evaluate the efficacy, safety, and tolerability of photodynamic therapy (PDT) using either conventional (C-PDT) or daylight (DL-PDT) protocols in adult and pediatric patients with CL.

Methods: A retrospective single-center study was conducted at the Dermatology Unit, University of Messina, Italy (January 2021-January 2025). Nine polymerase chain reaction (PCR)-confirmed CL patients (four pediatric, five adult) received three monthly sessions of either C-PDT or DL-PDT with 10% 5-aminolevulinic acid (ALA). Pain intensity was assessed using a visual analogue scale (VAS), and local or systemic adverse events were recorded. Clinical and dermoscopic outcomes were evaluated one year after the final session.

Results: Complete lesion clearance was observed in all patients in this cohort, with good cosmetic results and no recurrences. Median VAS scores were 6 for C-PDT and 1 for DL-PDT. Only mild transient erythema occurred, and no systemic adverse events were observed.

Conclusions: Both C-PDT and DL-PDT may represent safe, effective, and well-tolerated alternatives for CL. Their non-invasive nature, minimal discomfort, and good cosmetic outcomes make PDT a potential therapeutic option for pediatric and pain-sensitive patients.

Purpose: To evaluate the cycloplegic accuracy of the Vision Screener V100 (VS) and a desktop autorefractometer (TAR) in comparison with cycloplegic retinoscopy (CR) in children, and to compare the findings with current literature.

Methods: This prospective observational study included 50 pediatric patients (100 eyes) with a mean age of 9.8 ± 1.7 years. Cycloplegic measurements were obtained using the VS, TAR, and CR. Agreement between methods was analyzed using intraclass correlation coefficients (ICC) and Bland-Altman plots. Differences in spherical and cylindrical values were specifically assessed.

Results: TAR showed excellent agreement with CR, with ICC values above 0.95 for both spherical and cylindrical measurements. In contrast, the VS demonstrated moderate correlation for spherical values (ICC ≈ 0.82) and lower correlation for cylindrical values (ICC ≈ 0.60). Bland-Altman plots revealed that TAR had narrower limits of agreement with CR, particularly for astigmatism, whereas VS showed wider variability. These findings are consistent with previous reports indicating that non-cycloplegic photoscreening devices such as the VS tend to underestimate hyperopia and show reduced reliability in astigmatism assessment.

Conclusion: TAR demonstrates excellent concordance with CR under cycloplegia, whereas the VS shows notably lower accuracy, especially in detecting astigmatism. Our results highlight the importance of cycloplegic evaluation for accurately assessing refractive errors in children.