Photodiagnosis and photodynamic therapy最新文献

Background: Antibiotic resistance among multidrug-resistant pathogens necessitates alternative antimicrobial strategies. Photodynamic therapy (PDT) and sonodynamic therapy (SDT), particularly with methylene blue (MB), show promise but remain underexplored in clinical contexts.

Methods: We conducted an in vitro evaluation of MB-PDT and SDT against Staphylococcus aureus, a major cause of skin and soft tissue infections. Assays included growth curve analysis, scanning electron microscopy (SEM) to assess bacterial ultrastructure. A pilot clinical study in 20 healthy volunteers assessed in vivo antimicrobial efficacy and tolerability under standardized conditions.

Results: In vitro, MB demonstrated antimicrobial activity under PDT, with further potentiation by SDT and repeated irradiation. SEM confirmed structural disruption and lysis of S. aureus following combination therapy. In vivo, both MB-PDT and PDT+SDT achieved significant bacterial log reductions compared with baseline (p < 0.0001), with the highest efficacy observed under repeated irradiation plus SDT. The most significant effect was observed with repeated irradiation (2 × 30 J.cm⁻²) in combination with ultrasound (1 MHz, 1 W/cm²), with an average reduction of 2.424 log₁₀ (SD = 0.652).

Conclusions: MB-mediated PDT and PDT+SDT are safe, well tolerated, and effective against S. aureus on skin. These approaches provide localized antimicrobial activity independent of antibiotic resistance and warrant further optimization for clinical application.

Objective: Vaginal Intraepithelial Neoplasia (VaIN) is a precancerous condition that can progress to vaginal cancer if untreated. Photodynamic Therapy (PDT), recognized for its minimally invasive nature and favorable side effect profile, is increasingly employed for VaIN treatment; however, comprehensive evidence synthesis on its efficacy and safety remains limited. This study aims to comprehensively evaluate the efficacy and safety of 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) in treating VaIN.

Methods: We systematically searched PubMed, Embase, Web of Science, and Cochrane Library databases for studies evaluating PDT efficacy in VaIN. Primary outcomes were complete response (CR) rate and HPV clearance rate; secondary outcomes included recurrence rate and adverse events (AE). Meta-analysis was performed using Stata 18.0.

Results: Nine trials (421 patients) were included. Pooled outcomes: 6-month CR:87% (95% CI: 78%-94%), 12-month CR:84% (95% CI:76%-91%); 6-month HPV clearance:61% (95% CI:55%-66%), 12-month:73% (95% CI:67%-78%); 6-month HPV16/18 clearance:71% (95% CI:61%-80%), 12-month:76% (95% CI:63%-88%); 6-month recurrence:4% (95% CI:2%-8%), 12-month:7% (95% CI:0%-24%); AEs: Increased vaginal discharge (20%, 95% CI: 8%-36%), itching (25%, 95% CI: 1%-62%), burning sensation (23%, 95% CI: 1%-57%), abdominal pain (7%, 95% CI: 0%-21%), and mild vaginal bleeding (0%, 95% CI: 0%-3%). No serious AEs.

Conclusion: ALA-PDT demonstrates high efficacy and favorable safety in treating VaIN. However, as current evidence primarily stems from single-arm studies, future high-quality multicenter randomized controlled trials are essential to confirm these findings and directly compare ALA-PDT with standard therapies.

Objective: To investigate the incidence of dry eye syndrome following refractive corneal surgery and identify prognostic factors, thereby providing evidence-based guidance for precise clinical assessment and individualized management.

Methods: A retrospective cohort study was conducted including 778 patients (1,598 eyes) aged 18-45 years who underwent refractive corneal surgery at our hospital between January and December 2020. Surgical procedures included LASIK, FS-LASIK, PRK, Smart transepithelial photorefractive keratectomy, and ICL implantation. Comprehensive preoperative ophthalmic examinations were performed, including assessment of dry eye-related parameters such as tear meniscus height and tear film break-up time (BUT). Subjective symptoms were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire. Dry eye symptoms were assessed at 2 months postoperatively. Univariate analysis and multivariate logistic regression analysis were employed to identify independent risk factors for postoperative dry eye development.

Results: Among the 778 patients, 526 were male and 252 were female, with a mean age of 22.1±5.2 years. The overall incidence of dry eye at 2 months postoperatively was 41.4% (662/1,598 eyes). Ocular dryness was the most common symptom (78.5%), followed by foreign body sensation (65.3%) and photophobia (42.8%). Significant differences in dry eye incidence were observed among different surgical procedures (P=0.012). Surface ablation procedures (PRK + Smart transepithelial PRK) demonstrated an incidence of 45.7%, significantly higher than lamellar procedures (LASIK + FS-LASIK) at 39.7% (P=0.005). Univariate analysis revealed associations between postoperative dry eye and female gender, age 26-30 years, surface ablation procedures, preoperative tear meniscus height <0.2mm, and preoperative BUT <10s (P<0.05). Multivariate logistic regression analysis identified independent risk factors: female gender (OR=1.24, 95%CI: 1.02-1.51, P=0.032), surface ablation procedures (OR=1.32, 95%CI: 1.08-1.61, P=0.007), preoperative tear meniscus height <0.2mm (OR=1.58, 95%CI: 1.29-1.94, P<0.001), and preoperative BUT <10s (OR=1.45, 95%CI: 1.19-1.77, P<0.001).

Conclusion: Dry eye syndrome exhibits a relatively high incidence following refractive corneal surgery. Female gender, surface ablation procedures, and compromised preoperative tear film function constitute independent risk factors for postoperative dry eye development. Systematic preoperative assessment of tear film function is essential, with proactive intervention and individualized surgical planning recommended for high-risk patients to reduce postoperative dry eye incidence and enhance patient satisfaction.

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 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.

Purpose: To compare the corneal biomechanical differences of eyes with and without posterior staphyloma (PS) using Corneal Visualization Scheimpflug Technology (Corvis ST).

Methods: This is a cross-sectional study. The patients were classified into the PS group and control group. Corneal biomechanical parameters were measured by Corvis ST and compared between the two groups and among different PS subtypes.

Results: This study included 40 patients in the PS group and the control group respectively. The deformation amplitude at the highest concavity (HCDA), deflection amplitude at the highest concavity, max deflection amplitude (DLA max) and deformation amplitude ratio max at 2mm were significant higher in the PS group after adjusting the axial length (AL). After matching the AL, only the HCDA and DLA max were significantly greater in the PS group. There was no significant difference in corneal biomechanical parameters among the subtype PS. The A2 V, PD, Radius, HCDA, HCDLL, HCDLA, A2DLA, DLAmax, HC dArc Length, A2 dArc Length, dArc Length Max, DA Ratio Max, Integrated Radius are significantly correlated with PS. In distinguishing PS, DLA Max achieved the highest diagnostic performance, with an area under the receiver operating characteristic curve (AUROC) of 0.79 (95% CI,0.71-0.85), meanwhile, the area under the ROC curve of all data after the combination of gender and age was 0.813(95%CI:0.74-0.88).

Conclusion: Eyes with posterior staphyloma (PS) exhibit greater corneal deformability, elasticity, and viscoelasticity than controls, independent of PS location. These findings suggest PS impacts the anterior ocular wall, offering insights into PS pathogenesis.