Photodiagnosis and photodynamic therapy最新文献

Purpose: To evaluate the impact of repeated low-level red-light (RLRL) therapy on choroidal thickness and blood flow in pediatric myopia.

Methods: A three-month trial (April 1, 2023 - September 30, 2023) was conducted involving 44 children (ages 6-16) with myopia. Participants underwent RLRL therapy at home twice daily for five days per week, with each session lasting three minutes. Assessments at baseline, one month, and three months included cycloplegic refraction, best-corrected visual acuity (BCVA), intraocular pressure (IOP), ocular biometrics, swept-source optical coherence tomography angiography (SS-OCTA), slit-lamp, and fundus examinations.

Results: The study included 44 children (average age: 9.79 years; 56.82% male). RLRL therapy significantly increased subfoveal choroidal thickness (Baseline: 272.82 ± 64.01 μm; 1-month: 297.77 ± 72.94 μm; 3-month: 298.77 ± 77.17 μm, p = 0.001), reduced axial length (Baseline: 24.97 ± 1.47 mm; 3-month: 24.88 ± 1.38 mm, p = 0.002), and showed a marginal regression in spherical equivalent (p = 0.055). Significant elevations in choroidal vessel volume and thickness were noted, with positive correlations intensifying with distance from the fovea.

Conclusion: RLRL therapy shows promise in managing pediatric myopia by increasing choroidal vessel volume and thickness, potentially mitigating myopia progression.

Background: No study has quantitatively assessed tooth wear using a clinical quantitative light-induced fluorescence (QLF) system. This study aimed to compare fluorescence parameters (ΔF_wear) between the research QLF system (QLF-D) and clinical QLF system (Qraycam Pro) and evaluate the validity of both systems in detecting dentin exposure from tooth wear.

Methods: Thirty-five human molars and premolars were collected. Two blinded examiners conducted evaluations. Images from QLF-D and Qraycam Pro were captured and analyzed by the first examiner to calculate ΔF_wear, representing the maximum fluorescence intensity for occlusal wear. The stage of tooth wear was determined by the second examiner using the tooth wear index (TWI). The area of interest (AOI) was determined as the cusp without defects, such as caries or fractures. Only areas mutually agreed by both examiners were included in analysis. The Kruskal-Wallis test was conducted to assess differences in ΔF_wear between two devices. ROC analysis evaluated the validity of both systems in determining dentin exposure using AUROC.

Results: Thirty-eight AOIs were analyzed. ΔF_wear significantly increased with higher TWI scores. Median ΔF_wear for TWI scores (0, 1, and 2) were 6.9%, 10.3%, and 24.8%, respectively, for QLF-D, and 5.7%, 7.7%, and 23.9%, respectively, for Qraycam Pro. No significant differences in ΔF_wear were observed between QLF-D and Qraycam Pro for any TWI score. The AUROC for both systems was 0.95.

Conclusion: ΔF_wear was comparable between QLF-D and Qraycam Pro and demonstrated high validity in detecting dentin exposure. These findings support the clinical application of the QLF for quantitative tooth wear assessment.

Purpose: To investigate the correlations of spherical equivalent (SE), axial length (AL), and AL to corneal curvature radius ratio (AL/CR) with anterior segment biometrics in candidates for myopic refractive surgery.

Methods: Anterior segment biometrics of 2,478 myopic refractive surgery candidates measured by Pentacam were collected retrospectively. The anterior segment biometrics included anterior corneal curvature (ACC), posterior corneal curvature (PCC), white-to-white corneal diameter (WTW), central corneal thickness (CCT), corneal volume at 3mm (CV), anterior corneal astigmatism (ACA), posterior corneal astigmatism (PCA), anterior corneal eccentricity (ACE), posterior corneal eccentricity (PCE), anterior corneal asphericity (ACAP), posterior corneal asphericity (PCAP), anterior chamber depth (ACD), and anterior chamber volume (ACV). The eyes were divided into four groups according to the AL: group 1, AL≤24mm; group 2, 24mm

Results: In all AL groups, ACC was positively correlated with SE (r = 0.446 to 0.620) and negatively correlated with AL/CR (r = -0.704 to -0.894), whereas PCC was positively correlated with SE (r = 0.394 to 0.612) and negatively correlated with AL/CR (r = -0.606 to -0.787). WTW was positively correlated with SE (r = 0.304 to 0.474) in every group, and negatively correlated with AL/CR (r = -0.405 and -0.412) in group 1 and 4. ACA was positively correlated with AL (r = 0.310) and AL/CR (r = -0.333) in group 4. ACD was negatively correlated with AL (r = -0.304) in group 4, and positively correlated with AL/CR (r = -0.325) in group 2. ACV was positively correlated with SE (r = 0.344) in group 4, and positively correlated with AL (r = 0.303) in group 2. CCT, CV, PCA, ACE, PCE, ACAP, and PCAP was not significantly correlated with SE, AL, or AL/CR in any of group.

Conclusions: Differential correlations were observed between anterior segment biometrics and SE, AL, and AL/CR, suggesting that various myopia indicators have different effects on ocular structures. These findings may help identify the ocular structures that can be targeted of refractive surgery.

Carbon quantum dots (CQDs) are promising therapeutic agent due to their pro-oxidant, antioxidant, antiviral, antibacterial, and anticancer properties when exposed to visible light irradiation. Oxidative stress in bacteria is the main reason for bacteria death after exposure to blue light photoexcited quantum dots. Herein, we present the antibacterial activities of hydrophobic carbon quantum dots/polydimethylsiloxane nanocomposites, hydrophilic citric acid CQDs, and combinations of CQDs with methylene blue. We investigated the antirickettsial effect of hydrophilic and hydrophobic CQDs against Rickettsia slovaca, a tick-borne bacterial pathogen. Photodynamic activity against on rickettsiae reached 99.66% using CQDs with 470 nm blue light irradiation. Combining methylene blue with CQDs further enhanced the effect on rickettsial infection, achieving 99,98% efficacy. The obtained results reveal the in vitro antirickettsial properties of CQDs. Sequencing analysis on the genomic level of control and treated samples showed single nucleotide variants (SNVs). Based on snippy analysis SNVs were assigned to the rRNA genes, 16S rRNA and 30S rRNA genes. By freebayes analysis in treated samples, a stop-lost mutation was detected in pseudogene (RSL_RS06070), while the possible effect on down-stream genes including tsaD, acyl-CoA-desaturase, 30S ribosomal protein S6 and DUF424 family protein. The frameshift mutation was localized within clpB pseudogene belonging to stress-response heat-shock proteins.

Significance: Plantar warts, benign lesions on the soles of the feet, are caused by the human papillomavirus (HPV) infecting keratinocytes. Complete eradication of these warts is challenging, often leading to recurrences. This study evaluates the combined clinical efficacy of topical 5-aminolevulinic acid (5-ALA) photodynamic therapy (PDT) and fractional carbon dioxide (CO₂) laser treatment for recalcitrant plantar warts.

Approach: Data from 10 patients with recalcitrant plantar warts were analyzed. Initially, thickened hyperkeratotic tissue was removed using a super-pulsed CO₂ laser. This was followed by fractional laser application, after which a 20% 5-ALA cream was applied occlusively for 4 hours. Patients then received He-Ne laser irradiation for 30 minutes at an energy density of 100 mW/cm², with treatments spaced 4 weeks apart.

Results: The study included 10 participants aged 24 to 53 years (mean age: 33.4 ± 8.09 years). In total, 40 lesions were treated across 1 to 9 PDT sessions, with an average of 5.2 ± 2.86 sessions per patient. Complete clearance was achieved in 3 patients (30%), 4 patients (40%) showed an excellent response (≥80% improvement), while 2 patients had a partial response. One patient (10%) showed <50% improvement. The overall clearance rate was 70% (28 out of 40 lesions). Aside from temporary pain during the procedure and mild erythema post-treatment, one patient developed localized proliferative scarring. After a one-year follow-up, only one patient experienced recurrence.

Conclusions: The combination of 5-ALA PDT and fractional CO₂ laser therapy shows promise as an effective and safe alternative for treating persistent plantar warts.

Background: To investigate the retinal microcirculation in mild preeclampsia (PE) without obvious retinopathy in high-altitude native Tibetans by optical coherence tomography angiography (OCTA).

Methods: This study enrolled 64 mild preeclamptic pregnant women without retinopathy (group PPW), 63 healthy pregnant women (group HPW), and 61 healthy non-pregnant women (group HNPW). All participants were high-altitude native Tibetans who underwent OCTA, retinal thickness (RT), vascular density (VD), perfusion density (PD) and foveal avascular zone (FAZ) parameters were measured in the macula. Differences in these parameters among the groups were compared, and the correlations of these parameters with blood pressure were evaluated.

Results: In the entire macula, VD and PD were significantly lower in group PPW than in group HPW and HNPW (p < 0.05). In the subregions, VD was significantly different in fovea, parafovea and perifovea, PD was significantly different in parafovea and perifovea among the three groups (p < 0.05), the further pairwise comparisons showed VD and PD in parafovea and perifovea were lower in group PPW than in group HPW, and VD and PD in perifovea were lower in group PPW than in group HNPW (p < 0.05). RT and FAZ parameters did not differ among the groups (P > 0.05). VD and PD exhibited negative correlations with SBP and DBP (p < 0.05).

Conclusion: OCTA can objectively evaluate diminished microcirculation in mild PE without obvious retinopathy among high-altitude native Tibetans, and provide a crucial time window for early screening of PE-induced retinopathy.

Background: Frequently recurrence of genital herpes imposes significant physical and psychological burdens on patients, while existing treatments are often ineffective in preventing recurrence. Previous studies have indicated that photodynamic therapy (PDT) showed promising outcomes in the treatment of labial herpes simplex virus (HSV) infections; however, its efficacy for genital herpes remained unclear.

Method: The study screened patients with genital herpes at Daping Hospital from July 2020 to May 2024. Patients were divided into two groups based on whether they received PDT treatment. Over a one-year follow-up period, patients' healing time and recurrence rates were compared between the two groups. The cumulative incidence of recurrence and restricted mean survival time (RMST) were used to assess outcomes. Propensity score matching (PSM) was employed to minimize bias.

Result: A total of 41 patients enrolled in our study, with 8 (19.5%) received PDT. The non-PDT group exhibited a slower skin lesion healing time, averaging at 7.2 days compared to 5.4 days in the PDT group. A significant difference was observed in the cumulative incidence of recurrence between the PDT and non-PDT groups (37.5% versus 71.4%) after PSM. The RMST in the PDT group was 9.94 days, compared to 5.13 days in the non-PDT group before PSM, and 4.14 after PSM.

Conclusion: Our study demonstrated that the PDT effectively reduced lesion recovery time and delayed recurrences of genital herpes. We recommend considering PDT as a potential treatment option for patients with recurrent genital herpes.

Background: Between 2003 and 2016, 546 patients in our clinic discontinued outpatient treatment for actinic keratoses (AKs) using conventional photodynamic therapy (PDT) because of intolerable pain, thereby necessitating the use of a less painful procedure. Therefore, we developed a novel off-label PDT protocol: 'PDT light'.

Methods: Laser-assisted low irradiance PDT (li-PDT) was performed beginning in 2014. The dosage was gradually lowered to 8-12 J/cm² in 2018, so that we achieved considerable pain reduction while maintaining comparable therapeutic efficacy. A further considerable reduction in pain was achieved from 2018 onwards by combining the advantages of li-PDT with daylight PDT (DLPDT), thereby resulting in 2018 in the new technique 'PDT light'. Patients with AK Olsen grades 1 or 2 and field cancerization initially received a mild-fractionated CO2 laser pretreatment prior to MAL-incubation (methyl aminolaevulinate, Metvix ®) under occlusion for 1.5-3 h. Then, patients were illuminated on average for 1.02 min with the Aktilite-LED and, after application of an UV-screen on the illuminated area, sent out into daylight for 1 h.

Results: Between March and November 2019, we successfully treated 152 cases using the enhanced 'PDT light' procedure, with 137 cases achieving at follow-up 1 (on average after 8.14 months) good-to-excellent clearance rates (CLA and CLB together 90%) and minimal adverse effects.

Conclusions: The novel 'PDT light' protocol proved to be an excellent and nearly painless method with an average visual-analogue scale (VAS) score of 1.19. Additional advantages included reduced illumination time, shorter outpatient stays in the clinic, fewer adverse effects, and better patient compliance than with DLPDT alone.