Purpose To evaluate shortterm visual acuity effects of a single photodynamic therapy(PDT) treatment with Visudyne (CIBA Vision Corp, Duluth, Ga) for choroidal neovascularization (CNV) in age-related macular degeneration (AMD). Methods Definitely diagnostic AMD patients with classic CNV were treated with PDT (5 cases, 7 eyes). The data of visual acuity testing, ophthalmic examination, color photographs, optic coherence tomography, fluorescein angiograms and indocyanine green angiogram before photodynamic therapy and 1 week ,1 month after it were used to evaluate the effects of a single treatment of PDT with Visudyne. Results The visual acuity of all the treated eyes at the follow-up examination at 1 month after PDT were not reduced. Distinct reduction of fluorescein leakage from CNV was noted in all patients by 1 week after PDT. Fluorescein leakage from a portion of the CNV reappeared by 1 month after treatment in 2 eyes. Conclusion PDT with Visudyne achieved short-term cessation of fluorescein leakage from CNV without loss of vision or growth of classic CNV in some patwo ients with AMD. (Chin J Ocul Fundus Dis,2000,16:213-216)
ObjectiveTo systematically evaluate the efficacy and safety of photodynamic therapy (PDT) for acne vulgaris. MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and VIP databases were electronically searched from inception to August 9th, 2013, to collect randomized controlled trials (RCTs) about PDT for acne vulgaris. References of included studies were also retrieved. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.2 software. ResultsA total of 8 RCTs involving 271 patients were included. Because the interventions of included RCTs were different, meta-analysis or descriptive analysis was conducted for studies with the same intervention. The results of meta-analysis showed that ALA-red light-PDT was better than red light alone in clinical remission rate (RR=1.78, 95%CI 1.30 to 2.43, P<0.05). The results of descriptive analysis showed that:the effect of ALA-IPL-PDT was better than IPL alone, the effect of MAL-red light-PDT was better than red light alone, and the effect of MAL-red light-PDT was similar to MAL-IPL-PDT. ConclusionCurrent evidence shows PDT is effective for acne vulgaris. Adverse reactions including burning pricking pain, erythema, hydroderma, hyperpigmentation and acneiform eruption etc. are tolerated by most patients. Due to limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
Objective To summarize the therapeutic effect and clinical characteristics of repetitive photodynamic therapy (PDT) for patients with exudative age-related macular degeneration (AMD). Methods The clinical data from 78 patients (94 eyes) with exudative AMD who had undergone PDT from July, 2002 to March, 2005 were retrospectively analyzed. The average age of the patients was 68.4, and the treated times was 132 (mean 1.4). Thirty eyes underwent PDT 68 times, including twice in 22 eyes (73.3%), 3 times in 7 eyes (23.3%), and 6 times in 1 eye (3.3%). The follow-up period lasted 3-32 months with the average of 16.7 months. Results In the final follow-up examination, the results of fundus fluorescein angiography or combined with indocyanine green angiography showed that the leakage of choroidal neovascularization (CNV) stopped in 14 eyes (46.7%), reduced in 12 (40%), and remained in 4 (13.3%). Compared with the condition before first PDT, the correct visual acuity increased ge;2 lines in 7 eyes (23.3%), changed plusmn;1 line in 14 eyes (43.3%), and decreased ge;2 lines in 9 eyes (30%) in the final examination. After first PDT, the best corrected visual acuity increased ge;2 lines in 13 eyes (43.3%), changed plusmn;1 line in 12 eyes (40%), and decreased ge;2 lines in 5 eyes (16.7%). During the follow-up period, the best corrected visual acuity occurred after first PDT in 24 eyes (80%), after second PDT in 5 eyes (16.7%), and after third PDT in 1 eye (3.3%). Conclusions In patients undergone repetitive PDT, CNV in most of the affected eyes completely or partly closed and the visual acuity improved or remained still in 67.8% of the patients in the final follow-up examination. The best correct visual acuity mainly happened after the first PDT, and as the times of PDT increased, the probability of the best correct visual acuity decreased. (Chin J Ocul Fundus Dis, 2006, 22: 220-223)
ObjectiveTo evaluate the efficacy and safety of photodynamic treatment for port wine stains compared with gold standard pulsed dye laser.MethodsA literature search was performed in PubMed, CENTRAL, Embase, Web of Science, China National Knowledge Infrastructure, CQVIP, and Wanfang to identify the clinical randomized controlled studies on photodynamic therapy, pulsed dye laser, and port wine stains, which were published from the establishment of the databases to April 3rd, 2021, and the outcome measurements included effective rate and incidence of adverse reactions. Data were extracted and meta-analysis was performed with RevMan5.3 software, and the quality of evidence was evaluated according to GRADE standards.ResultsThree randomized controlled studies were included, with a total of 268 cases of port wine stains. Meta-analysis results showed that there was no statistically significant difference in the efficacy [relative risk (RR) =1.08, 95% confidence interval (CI) (0.89, 1.32), P=0.42] or the incidence of pigmentation [RR=1.03, 95%CI (0.65, 1.65), P=0.89] between photodynamic therapy and pulsed dye laser in the treatment of port wine stains.ConclusionsThe effectiveness and the occurrence of pigmentation of photodynamic therapy on port wine stains are not significantly different from those of pulsed dye laser. Photodynamic therapy is an effective and safe method for the treatment of port wine stains. Due to the limited literature included, large-scale prospective clinical trials are still needed to verify the conclusion.
ObjectiveTo observe and analyze the clinical and imaging features of eyes with cystoid macular degeneration (CMD) secondary to chronic central serous chorioretinopathy (cCSC). MethodsA retrospective clinical study. From February 2018 to June 2023, 9 patients of 15 eyes with cCSC secondary CMD diagnosed by ophthalmology examination in Yunnan University Affiliated Hospital were included in the study. All patients were male. The age was (53.67±3.83) years. The cases of binocular and monocular were 6 and 3 respectively. The visual acuity of the affected eye ranges from 0.02 to 0.1, which cannot be corrected. Visual acuity decreased and the duration of shadow occlusion was ＞1 year. Half dose photodynamic therapy (PDT) was performed on 8 eyes. All the patients underwent the best corrected visual acuity, posterior mydriatic fundus color photography, infrared fundus photography (IR), fundus autofluorescence (AF), fluorescein fundus angiography (FFA), optical coherence tomography (OCT), and multi-wavelength dazzling imaging (MC). The patients who received half dose PDT were followed up until 3 months after treatment. Patients who did not receive treatment were followed up to 2 years after the first diagnosis. ResultsThe light reflection in macular area decreased or disappeared in all eyes, and abnormal macular pigmentation was observed in 12 eyes. IR examination showed diffuse patchy weak fluorescence in the macular area in all affected eyes, and dotted strong fluorescence in the periphery. Fundus AF examination showed disc-like weak AF in the macular area, and scattered small amounts of strong AF in the middle and margins, among which the retinal pigment epithelium (RPE) atrophy trace in the macular area was observed in 7 eyes. By MC examination, the green signal in the macular area of the posterior pole of all affected eyes was uneven and mottled. FFA examination showed that no abnormal fluorescein leakage was observed in 15 eyes and 8 eyes showed strong fluorescence caused by diffuse permeation fluorescence. A small amount of active fluorescein was found in 7 eyes. OCT examination showed that there were several cystic cavities of different sizes in all the affected eyes, RPE atrophied to different degrees, and RPE cell compensatory ridges and tubular structures in the outer retina were seen in 6 eyes; 7 eyes with CMD and active leakage showed signs of subcortical fluid accumulation. Choroidal hypertrophy was seen in all affected eyes, with significant expansion of the great vascular layer and compression of the middle vascular layer and capillary layer. In 8 eyes treated with half-dose PDT, 6 eyes were ineffective at 3 months after treatment. The treatment was effective in 2 eyes. In 7 eyes that did not receive half-dose PDT, CMD structure did not improve significantly after 2 years of follow-up. The visual acuity decreased with the prolongation of the disease. ConclusionsCMD is more common in cCSC with a long course of disease, which has significant effects on vision and poor prognosis. Fundus color photography shows that the reflection in the macular area of the pole is weakened or disappeared, which may be combined with macular abnormal pigmentation. IR and AF examination show uneven fluorescence in macular area. The green signal in macular area is not uniform according to MC inspection. FFA shows strong fluorescence caused by diffuse permeable fluorescence and fluorescein leakage in active lesions. OCT examination shows that multiple small sacs or connections between sacs were broken and fused, and RPE atrophied to varying degrees.
Objective To assess the effectiveness and safety of photodynamic therapy (PDT) for patients with nonresectable bile duct cancer. Methods Two reviewers independently searched The Cochrane Library (issue 4, 2006), MEDLINE (1966 to February 2007), CNKI (1994 to February 2007) and VIP (1989 to February 2007), respectively. The quality of included studies was assessed according to the guidance in the Cochrane Handbook of Systematic Reviews of Interventions. Results Two randomized controlled trials involving 71 patients with nonresectable bile duct cancer met the inclusion criteria and were included. Both of these trials reported that the median survival time in patients who were treated with endoprostheses and PDT was longer than for those treated with endoprostheses alone (493 days versus 98 days, and 21 months versus 7 months, in the two trials respectively) One trial reported that the global quality of life in patients in the PDT with endoprostheses group was significantly better than that for the endoprostheses alone group: the difference of Karnofshy index between the two groups was 25.4 (14.4-36.3). The other trial reported no difference between the two groups. No severe adverse effects were observed during either trial. Conclusion Current evidence demonstrates that PDT can improve the survival time of patients with nonresectable bile duct cancer, and reduce the burden of treatment. The treatment might increase biliary infectious rate, but this can be managed by antibiotics therapy. No severe adverse effects are observed. More randomized controlled trials, with large sample sizes, may lead to more accurate results.
bjectiveTo study the therapeutic effect and mechanism of photodynamic therapy (PDT) to the nude mice model of pancreatic cancer by intratumoral injecting photosensitizers hematoporphyrin derivatives (HpD), hypocrellin A (HA) and 2butylamino2demethoxyhypocrellin A (2BA2DMHA).MethodsThe animal model of human pancreatic cancer was developed by injecting human pancreatic cancer cells SW1990 into the back of the nude mice. After photosensitizers HpD, HA and 2BA2DMHA was given by the intratumoral injection, the 632.8 nm HeNe laser was used to irradiate the tumor. The curative effect was recorded and factorⅧ was used in the immunohistochemical staining to study the vessel change. ResultsPDT can destroy the pancreatic neoplasm, the tumor growth rate was significantly reduced after PDT. The immunohistochemical staining showed PDT could make injury to vessel endothelial cell.ConclusionPDT can induce injuries of pancreatic cancer; vascular injury is an important way to exert function.
Central serous chorioretinopathy (CSC) is a common macular disease, mainly manifested as a plasma detachment of the macula. Photodynamic therapy (PDT) is an effective treatment for CSC, but with the shortage of the photosensitizer Verteporfin, the effective treatment of CSC has become a common concern for ophthalmologists. In this paper, based on the latest research results on the relationship between the changes in the thickness of the outer nuclear layer and the natural course of the disease and PDT therapy, we propose that patients with CSC should receive effective treatment as early as possible to prevent irreversible damage to visual function due to the thinning of the outer nuclear layer. In addition to PDT, it is recommended that laser photocoagulation or subthreshold micropulse laser treatment of the leaking spot should be considered first, depending on the presence of the leaking spot and its location in relation to the macula center. Anti-vascular endothelial growth factor therapy can be considered if there is a combination of choroidal neovascularization and/or polypoidal choroidal vasculopathy. Other treatments that have not been demonstrated to be effective in evidence-based medicine are not recommended.
ObjectivesTo systematically review the efficacy of photodynamic therapy (PDT) and sodium hypochlorite (NaClO) for removal of Enterococcus faecalis (E. faecalis) in root canal therapy.MethodsWe searched PubMed, EMbase, The Cochrane Library, CBM, WanFang Data, CNKI and VIP databases to collect randomized controlled trials (RCTs) on PDT versus NaClO for removal of E. faecalis from inception to October, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software.ResultsA total of 17 RCTs were included. The results of meta-analysis showed that, comparing PDT with 5.25%NaClO, there was no significant difference in the remaining colony-forming units (CFUs) of E. faecalis between both groups (MD=0.55, 95%CI −0.72 to 1.83, P=0.40); comparing PDT with 2.5%NaClO, there was no significant difference in the remaining CFUs of E. faecalis between both groups (MD=0.54, 95%CI −0.32 to 1.41, P=0.22).ConclusionsThe current evidence indicates that PDT and NaClO show similar efficacy against the intracanal E. faecalis. Due to the limited quality and quantity of included studies, more high quality studies are required to verify the above conclusions.
Objective To explore the mechanism of laser and photodynamic therapy (PDT) of hemangioma. Methods A total of 48 6-month-old male chickens were divided into 6 groups, with 8 in each group. The side with the untreated comb served as the control. Group A was the control group. In groups B and C, the combs received laser irradiation once of 10 J/cm2 and 15 J/cm2, respectively, for 2-3 minutes. In group D, hematoporphyrin monomethyl ether (HMME) of 10 mg/kg was injected into the left-side axillary vein once. In groups E and F, the combs received laser irradiation of 10 J/cm2 and 15 J/cm2, respectively, after 10 mg/kg HMME was injected for 10 minutes into the left-side axillary vein. On the 14th day, HE staining was performed and the decrease rate of the number of capillary vessels was calculated. Besides, TUNEL stainingwas conducted to observe the condition of capillary endothel ium apoptosis. Results No animal died after the operation,the combs in groups A and D had no obvious changes in shape and color, but the ones in the other groups had leukasmus, edema, necrosis and dark crust. According to histological observation, in groups A and D, the combs had no obvious changes. But in the other groups, tissue exudation, edema, inflammatory cell exudation, decreasing number of vessels, waning vascular cal iber, thrombus, and partial capillary endothel ium apoptosis were found. The decrease rate of the number of capillary vessels was as follows: 7.87% ± 2.50% in group A, 48.58% ± 5.10% in group B, 57.58% ± 8.17% in group C, 8.84% ± 3.13% in group D, 61.26% ± 16.87% in group E and 68.56% ± 10.54% in group F. The apoptosis index in all groups was 1.05 ± 0.76, 82.22 ± 6.18, 94.13 ± 1.64, 1.38 ± 0.52, 101.88 ± 5.94, 104.88 ± 6.22, respectively. There were significant differences between groups B, C, E, F and groups A, D in the above two items (P lt; 0.01). There were significant differences between groups B and E as well as between groups C and F (P lt; 0.01). There were no significant differences between groups B and C as well as groups E and F (P gt; 0.05). Conclusion Apoptosis of capillary endothel ium maybe play an important role in the laser and photodynamic therapy of hemangioma apart from the direct effect of laser.