Photodiagnosis and photodynamic therapy最新文献

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.

Purpose: This study investigated the effects of laughter exercise on IOP, anterior and posterior segment parameters in healthy adults.

Methods: This study involved 23 healthy adults who underwent baseline and post-intervention measurements of IOP and ocular structures. Using swept-source OCT(SS-OCT), we quantified Schlemm's canal area(SCAR) and trabecular meshwork thickness across four quadrants, and assessed posterior segment parameters with a 24 × 20 mm ultra-widefield protocol. Measurements were repeated at 1, 15, 30, and 60 minutes after a 5-minute standardized laughter exercise to analyze longitudinal changes and IOP correlations.

Results: IOP significantly decreased at 1, 15, and 30 minutes after laughter exercise (all p<0.01), then recovered at 60 minutes(p=0.131). The nasal SCAR significantly enlarged at 15 minutes(p<0.001) and 30 minutes post-exercise(p=0.004). Temporal SCAR only showed significant increase at 1 minute post-exercise(p=0.025). The superior SCAR significantly enlarged at 1 minute(p=0.008) and 30 minutes(p=0.041) post-exercise. Inferior SCAR remained stable throughout the study period(p=0.204). The trabecular meshwork thickness in all 4 quadrants only exhitbited significant increase at 1 minute post-exercise(all p<0.01). No significant changes in chorioretinal parameters were noted(all p>0.05). In the multivariate model, retinal superficial capillary plexus vessel density positively corelated with IOP(β=4.00, p=0.009), whereas nasal SCAR demonstrated a negative correlation(β=-2.40, p=0.003).

Conclusions: The anterior and posterior segment demonstrated distinct responses to a standardized laughter exercise. The IOP changes are associated with the expansion of Schlemm's canal. Further research is warranted to determine the efficacy of laughter exercise as a non-pharmacological adjunct for IOP control.

Purpose: To evaluate the choroidal thickness (CT), central retinal artery (CRA), ophthalmic artery (OA), internal carotid artery (ICA) and common carotid artery (CCA) hemodynamic parameters and the carotid intima-media thickness (CIMT) in patients with metabolic dysfunction-associated steatotic liver disease (MASLD).

Methods: This prospective study included 98 MASLD patients and 30 healthy controls. MASLD patients were classified into three stages via liver ultrasonography.

Results: CT was significantly decreased at all measured points in Stage 2 and Stage 3 MASLD patients versus controls and at subfoveal and nasal (500-1000-1500 µm) points in Stage 3 compared to Stage 1(all p < 0.05). A significant relationship was observed between CT and age, MASLD stage, and GGT levels. OA peak sistolik velocity (PSV), ICA PSV, enddiastolic velocity (EDV), and CCA EDV values were significantly lower in Stage 3 compared to the control group and Stage 1 while the ICA PSV and CCA EDV values were significantly lower in Stage 3 compared to Stage 2 (all p < 0.05). The CCA resistive index (RI) and pulsatile index (PI) were significantly higher in Stage 3 than in the control group and Stage 1 as with the CCA PI value in Stage 3 compared to Stage 2 (p = 0.026, p = 0.035, p = 0.011, p = 0.014, p = 0.022, respectively). CIMT was significantly higher in Stage 3 than in controls (p = 0.005).

Conclusions: MASLD affects ocular vascular structures and may be associated with an increased risk of ocular pathologies.

Purpose: To assess the levels of leucine-rich α-2 glycoprotein-1 (LRG1) in aqueous humour and serum of patients with retinal vein occlusion (RVO) and to investigate the correlation between LRG1 and RVO.

Methods: This is a cross-sectional study. This study involved 41 patients with retinal vein occlusion (RVO), comprising 15 individuals with central retinal vein occlusion (CRVO), 26 with branch retinal vein occlusion (BRVO), and 36 with cataracts. The study cohort was further categorized into ischemia (n=15) and non-ischemic subtypes (n=26). Aqueous humor (100μL) was obtained after intravitreal anti-VEGF injection or cataract surgery. LRG1 was quantified using ELISA kits.

Results: The aqueous and serum concentrations of LRG1 were considerably elevated in the eyes of individuals with RVO compared to controls (All P<0.001).Additionally, serum LRG1 levels in the ischemic group were significantly elevated compared to the non-ischemic and control groups (P<0.001).Nonetheless, the aqueous LRG1 levels exhibited no significant change between the ischemic and non-ischemic groups (P=0.758).The serum LRG1 concentration above 26.53 μg/ml achieves the maximum Youden index of 0.7556 in the ROC analysis. The area under the ROC curve for serum LRG1 is 0.874 (P<0.0001).

Conclusion: Patients with RVO had greater serum LRG1 levels. Furthermore, ischemic RVO had considerably higher serum LRG1 levels than non-ischemic patients. Consequently, serum LRG1 may be associated with the occurrence and development of retinal ischemia.

Background: Repeated low-level red-light (RLRL) therapy has emerged as a promising non-invasive intervention for myopia control. However, the predictive factors underlying its efficacy remain insufficiently explored.

Methods: This multicenter cohort study included 538 pediatric patients who underwent RLRL treatment with a minimum follow-up of one year. Baseline ocular parameters and dynamic changes in axial length (AL) and choroidal thickness (ChT) over three months were collected. Multiple feature selection approaches-LASSO regression, Boruta, recursive elimination, and multivariate regression-were applied. Seven machine learning algorithms were trained, and their performance was evaluated using the area under the curve (AUC), sensitivity, specificity, and F1 score. SHAP and LIME analyses were utilized for interpretability.

Results: Logistic regression and gradient boosting models demonstrated the highest discriminative ability. XGBoost achieved optimal performance (AUC: 0.90-0.92; accuracy: 87.7-88.2%; F1 score: 0.72-0.86). Across one- and two-year prediction models, six stable predictors were identified: age, baseline AL, anterior chamber depth (ACD), RNFL thickness at the temporal inferior quadrant (TI), ChangeAL, and ChangeChT. SHAP analysis revealed that ChangeAL was the dominant short-term predictor, whereas ChangeChT was most influential for long-term outcomes. Older age and greater choroidal thickening were consistently associated with a protective effect against myopia progression.

Conclusions: We developed and validated an interpretable machine learning model that accurately predicts short- and long-term outcomes of RLRL therapy in children. ChangeAL and ChangeChT serve as key dynamic biomarkers for treatment monitoring. These findings provide a foundation for personalized clinical decision-making in myopia management.