Photodiagnosis and photodynamic therapy最新文献

Purpose: Refractory diabetic macular edema (DME) remains a therapeutic challenge despite anti-vascular endothelial growth factor (anti-VEGF) treatment. This study compares the efficacy and safety of intravitreal dexamethasone (DEX) implants and conbercept in patients with refractory DME.

Methods: This retrospective cohort study included 317 eyes from 317 patients with refractory DME who had received at least three prior anti-VEGF injections. Patients were divided into two groups based on the treatment they received: the DEX group (n = 125) and the conbercept group (n = 192). Best-corrected visual acuity (BCVA) was recorded in logarithm of the Minimum Angle of Resolution (logMAR) units. Central macular thickness (CMT), intraocular pressure (IOP), and adverse events were assessed at baseline and 3, 6, and 12 months after treatment.

Results: Both groups showed significant improvements in BCVA and reductions in CMT. The DEX group achieved greater BCVA gains at 3 and 6 months (P < 0.05), but differences were not significant at 12 months (P = 0.229). CMT reduction was more pronounced in the DEX group at 3 and 12 months (P < 0.05), with no significant difference observed at 6 months (P > 0.05). IOP increased significantly in the DEX group at each follow-up visit (all P < 0.001), with a higher incidence of ocular hypertension (21.6% vs. 3.6%, P < 0.001). Cataract surgery was more common in the DEX group (8.8% vs. 2.6%, P = 0.014).

Conclusions: DEX implants provide better short-term efficacy but with higher risks, while conbercept offers safer outcomes for refractory DME.

Background: Hemoporfin-mediated photodynamic therapy (HMME-PDT) is an established treatment for port-wine stains (PWS), but hypertrophic or nodular lesions often respond poorly, and the molecular mechanisms that govern treatment sensitivity remain unclear. The Ataxia Telangiectasia Mutated (ATM)-Seryl-tRNA synthetase (SerRS)-Vascular endothelial growth factor A (VEGFA) pathway has recently been implicated in hypoxia- and DNA damage-driven angiogenesis.

Methods: Human umbilical vein endothelial cells (HUVECs) were treated with HMME-PDT and/or all-trans retinoic acid (tRA). Cell viability was assessed by CCK-8 assay, angiogenic activity by tube formation assay, and mRNA expression of ATM, SerRS and VEGFA by quantitative real-time PCR. Protein levels of ATM, phosphorylated ATM (p-ATM), SerRS and VEGFA were evaluated by Western blotting.

Results: HMME-PDT significantly inhibited HUVEC viability and tube formation in a concentration- and light dose-dependent manner. HMME-PDT decreased total ATM and, more prominently, p-ATM, while upregulating SerRS and downregulating VEGFA at both mRNA and protein levels. tRA alone dose- and time-dependently reduced HUVEC proliferation, increased SerRS expression and suppressed VEGFA expression. Combined treatment with tRA and HMME-PDT produced the greatest inhibition of tube formation and the strongest induction of SerRS together with the most pronounced reduction in VEGFA, whereas changes in ATM and p-ATM were mainly driven by HMME-PDT.

Conclusions: HMME-PDT exerts anti-angiogenic effects at least in part by modulating the ATM-SerRS-VEGFA axis in endothelial cells. Pharmacologic upregulation of SerRS by tRA further enhances VEGFA suppression and inhibition of angiogenesis, indicating a synergistic interaction between tRA and HMME-PDT. These findings provide a mechanistic rationale for tRA-augmented HMME-PDT as a potential strategy to improve outcomes in refractory PWS.

A 65-year-old male presented with cauliflower-like growths on the penis for two years. Physical examination revealed erythema and cutaneous atrophy on the prepuce, glans, and external urethral meatus, with diffuse cauliflower-like proliferations on this basis. Based on the clinical and histopathological findings, a diagnosis of condylomata acuminata (CA) with concomitant lichen sclerosus (LS) was made. The patient received a multimodal treatment involving 5-aminolevulinic acid photodynamic therapy (ALA-PDT), Holmium-laser, and curettage, which led to significant improvement of the lesions. No recurrence was observed during a 4-year follow-up period.

Background: Klebsiella pneumoniae, a prominent member of the ESKAPE pathogen group (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species), represents a serious concern in postoperative gynaecological infections due to its multidrug resistance (MDR) and strong biofilm-forming ability. The limited efficacy of conventional antibiotics against such infections underscores the need for innovative combinatorial strategies, such as bacteriophage therapy and phototherapy.

Aims: This study aimed to evaluate the synergistic antibacterial potential of bacteriophage therapy and blue light (450 nm) phototherapy against biofilm-associated MDR K. pneumoniae isolated from a post- cesarean wound infection.

Methods: A clinically isolated MDR K. pneumoniae strain was characterised, and biofilms were treated with phage, blue light, or sequential phage-light combinations. Crystal violet assays and microscopy quantified biofilm biomass reduction, while synergy was analysed using the Bliss independence model. Phage stability under blue light and cytocompatibility with HiFi™ human PBMCs were also assessed, along with cytokine profiling.

Results: The combined phage-blue light treatment achieved an 82.3% reduction in biofilm biomass, significantly surpassing either monotherapy (p < 0.0001). Sequence-dependent synergy was observed, with Phage→Light treatments showing stronger early effects (6 h). Phage viability remained unaffected by blue light, and PBMC assays confirmed high cytocompatibility with no detectable cytokine induction. Mechanistically, blue light-induced ROS disrupted the biofilm matrix, facilitating enhanced phage penetration and infection.

Conclusions: Bacteriophage-blue light combination therapy represents a safe, synergistic, and resistance-mitigating approach for managing MDR K. pneumoniae biofilm infections, offering promising translational potential in postoperative gynaecological wound care.

Purpose: To map research hotspots and emerging trends of Optical Coherence Tomography (OCT) and Optical Coherence Tomography Angiography (OCTA) in Age-related Macular Degeneration (AMD) from 2015-2024 using bibliometric analysis.

Methods: We searched the Web of Science Core Collection (2015-2024) on January 2025, identified 2,471 English-language articles on OCT/OCTA in AMD, and extracted data on countries, institutions, journals, keywords, and citations. CiteSpace 6.4 and Excel were used for co-occurrence/co-citation analyses and visualization; H-indexes were compiled for countries and institutions.

Results: Seventy-eight countries/regions contributed to the field; the United States led in publications and H-index, followed by China. Among 200 institutions, the University of California System produced the most studies and showed the highest influence. Publication output increased steadily (R²≈0.69). Core topics clustered around geographic atrophy (GA), choroidal neovascularization (CNV), ranibizumab, OCT, and AMD. Recent keyword bursts highlighted macular neovascularization (MNV), hyperreflective foci (HRF), deep learning, impact, and growth. High-impact literature underscored OCT/OCTA's noninvasive vascular imaging utility, anti-VEGF treatment outcomes, GA progression metrics, and rapid advances in AI-driven detection/segmentation and prognostication. Meta-analyses reported high diagnostic accuracy of OCTA for CNV, while technical challenges (e.g., signal-to-noise) persist. Emerging themes include multimodal integration, biomarkers such as hyperreflective foci for prognosis, and time-series/AI models for predicting GA/CNV trajectories and personalizing treatment intervals.

Conclusion: OCT and OCTA research in AMD has expanded substantially, with the U.S. and leading academic centers driving influence. Integrating AI with OCT/OCTA enables earlier detection, refined phenotyping, and data-informed, personalized management. Advancing precision and standardization will further improve diagnostic accuracy and therapeutic decision-making in AMD.

Purpose: We aimed to compare the anterior corneal aberrometry between Pentacam HR, a Scheimpflug-based imaging system, and Peramis, an aberrometer that combines a pyramidal wavefront sensor with Placido-disk topography.

Methods: Myopic, otherwise healthy patients who were scheduled for refractive surgery were examined for anterior corneal aberration profiles using Pentacam HR and Peramis in a 4mm pupil-centered analysis zone. This profile included corneal total aberrations (TAs), lower-order aberrations (LOAs), higher-order aberrations (HOAs), trefoil (Z(3,-3), Z(3,3)), coma (Z(3,-1), Z(3,1)), and spherical aberrations (Z(4,0)). Subgroup analysis was performed according to the laterality of eyes and the severity of myopia. In addition to the root mean square micrometer (RMS µm), the aberrometry data were simultaneously presented as equivalent diopters to facilitate clinical understanding. A difference of less than 0.5 diopter or 0.3 RMS µm was considered clinically interchangeable.

Results: A total of 160 eyes from 80 patients were included. Pentacam HR consistently showed significantly higher corneal TAs, LOAs, HOAs, and SA in both eyes (p < 0.01). There was a moderate correlation for corneal TAs, LOAs, and coma aberrations (ICC: 0.39-0.59). In contrast, the correlation was poor for trefoil and spherical aberrations (ICC: 0.16-0.38) and almost non-existent for HOAs (ICC: 0.01-0.07). The width of the 95% limits of agreement was too large across all comparisons, exceeding 2 RMS µm for TAs and LOAs and 1 RMS µm for HOAs. It was also approximately 0.5 RMS µm for trefoil, coma, and spherical aberrations. Similar patterns were observed in subgroups, regardless of eye laterality or myopia severity.

Conclusions: Despite moderate correlations in some Zernike terms, the two systems could not be used interchangeably. This is important in pre-operative planning, where patients with higher HOAs might be/not be candidates for particular cataract or wavefront-based refractive surgeries.

Cancer is a serious health challenge, and an effective cancer treatment option is photodynamic therapy (PDT). Unfortunately, in clinical practice, PDT is hindered by poor delivery and stability of the photosensitizers, which are essential for conducting PDT, as well as by significant side effects and aggregation. The aim of this study was to incorporate the second-generation chlorin-based photosensitizer, Temoporfin, into silica nanoparticles (SiNPs) to improve the safety and efficacy of PDT. Due to their ability to control the delivery of oxygen to the tumor microenvironment, red blood cells (RBCs) were chosen as biological targets. Selective photodynamic damage to red blood cells may influence oxygen transport dynamics in the local microenvironment, suggesting a potential mechanism that could be relevant to tumor-associated hypoxia in future therapeutic models. Temoporfin was microemulsified, encapsulated within silica nanoparticles, and characterized for size, shape, and stability. Multiple photodynamic experiments were conducted with varying concentrations and exposure times to compare free Temoporfin and the encapsulated formulation. The formulation encapsulated in silica nanoparticles demonstrated photodynamic effects at much lower doses and shorter exposure times compared to the free formulation, largely due to improved light absorption, enhanced reactive oxygen species generation, and reduced aggregation of the photosensitizer within the silica polymer. The observations of this study provide a detailed reference for the design and fabrication of efficient photodynamic therapy systems, and the silica nanoparticles are encouraged to be used for sustained photosensitizer delivery. In addition, mathematical models were developed to relate the concentration of the drug to the time required to induce 50% RBC death (t₅₀) for both free and encapsulated Temoporfin. These models provide an initial estimate for refining PDT treatment parameters and can help limit extensive experimental optimization. Overall, the study underscores the efficacy of silica nanoparticles as drug carrier systems for photosensitizers and supports their use in developing more refined, efficient, and biocompatible PDT approaches. This approach can be particularly useful for future cancer treatment models and can be extended to other areas of biomedicine.

Background: This study aimed to assess the value of blood plasma autofluorescence spectroscopy in classifying renal injury after renal transplantation.

Methods: The researchers included 86 patients after kidney transplantation and established five classifications: stable group, tubular injury group, IgA nephropathy group, antibody-mediated rejection (ABMR) group, and mixed group. They also established two classification (stable and unstable) diagnostic models based on renal histopathological results. Clinical and laboratory test data of patients were integrated, peripheral blood was collected and blood plasma autofluorescence spectra were detected; postoperative injury classification models were constructed using principal component analysis (PCA) and support vector machine (SVM).

Results: Among the five-classification diagnostic models, the overall accuracy of the classification obtained after training the model with blood plasma autofluorescence spectra alone was 84%; the overall accuracy of the classification obtained after training the model with laboratory renal function indexes alone was only 36%; and the accuracy of the classification obtained after combining the two with blood plasma was 88%. In the dichotomous diagnostic model, blood plasma autofluorescence spectroscopy alone had an overall accuracy of 96.30%; laboratory renal function alone had an overall accuracy of 84%; and the combination of both had an accuracy of 100%.

Conclusions: Blood plasma autofluorescence spectroscopy has potential application in rapid, minimally invasive diagnosis of post-transplantation renal injury and identification of the type of injury.

Objective: This study aimed to evaluate the short-term efficacy of neuroplasticity-based binocular visual training compared with conventional spectacle correction combined with occlusion therapy in children diagnosed with ametropic amblyopia.

Methods: A single-center randomized controlled trial was conducted involving 70 children aged 4 to 16 years with a clinical diagnosis of amblyopia. Participants were randomly allocated to an intervention group (spectacle correction combined with 20 sessions of neuroplasticity training) or a control group (spectacle correction combined with occlusion therapy). Primary outcome measures included best corrected visual acuity (BCVA), stereoacuity, and binocular suppression index.

Results: Following 10 training sessions, participants in the intervention group demonstrated statistically significant improvement in BCVA, increasing from 0.72 to 0.88 in the right eye and from 0.70 to 0.90 in the left eye, with outcomes superior to the control group (both p < 0.001). Stereoacuity improved from 253.6 arc seconds (arcsec) to 160.7 arcsec in the intervention group, which was significantly greater than the improvement observed in the control group (250.4 arcsec to 132.7 arcsec); after adjusting for baseline stereoacuity differences using analysis of covariance (ANCOVA), the intergroup difference in corrected stereoacuity outcomes reached statistical significance (p = 0.001). The intervention group showed superior long-term stability of stereoacuity at 3-month follow-up (158.32 ± 35.21 arcseconds versus 145.24 ± 32.09 arcseconds in the control group, p = 0.023), and achieved a significantly higher rate of combined efficacy endpoint (stereoacuity improvement ≥30% plus perceptual eye alignment error ≤30 pixels, 85.7%) compared with the control group (62.3%, p < 0.01), which served as the core basis for the efficacy conclusion. The foveal suppression index decreased from 51.4% to 14.3% in the intervention group. No serious adverse events were reported during the intervention period.

Conclusions: Neuroplasticity training was associated with significant short-term improvements in BCVA and binocular visual function in children with amblyopia, demonstrating a favorable safety and efficacy profile. These findings support its potential application in clinical practice.

Objective: To evaluate the clinical outcomes and visual quality after Phorcides planned Contoura topography-guided femtosecond laser-assisted excimer laser in situ keratomileusis (TOPO-G FS-LASIK) for myopia and astigmatism correction.

Methods: Non-randomized retrospective study. 38 eyes in the high ocular residual astigmatism (HORA, >0.75D) group and 44 eyes in the low ocular residual (LORA, <0.75D) group were treated, and the accuracy was evaluated based on the Phorcides planned Contoura TOPO-G FS-LASIK. Routine examinations and specific tests, such as ocular aberrations, optical quality analysis system, a subjective visual quality questionnaire, and contrast sensitivity (CS), were measured and compared within and between groups preoperatively and postoperatively.

Results: At 6m postoperatively, manifest refractive spherical equivalent, uncorrected and corrected distance visual acuity, safety index, effectivity index, target-induced astigmatism, surgical-induced astigmatism, difference vector, angle of error, and correction index were similar in both HORA and LORA groups (P>0.05). Objective scatter index, modulation transfer function cut-off, visual acuity (VA) 100%, and all the CS were similar between the two groups preoperatively and postoperatively (P>0.05). But VA20%/9%, Strehl ratio, the CS of 1.5/3/6/12/18c/d in the HORA group, and 1.5/3/6c/d in the LORA group were significantly elevated 6m postoperatively. The subjective visual quality questionnaire scores were consistent both within and between groups preoperatively and 6m postoperatively.

Conclusions: Phorcides planned Contoura TOPO-G FS-LASIK achieved the predicted outcomes, demonstrating objective and universal applicability. Visual quality in the HORA group was significantly improved, especially the night vision and high-frequency spatial CS.