Objective To summarize the development, clinical application, advantages and disadvantages, and future prospects of parathyroid autofluorescence in recent years. MethodThe literatures related to the research progress of parathyroid autofluorescence in recent years were searched, and launched a specific discussion. Results Autofluorescence of parathyroid gland was still in its infancy at home and abroad. The existing studies had shown that this technique was superior to visual recognition and could reduce the incidence of postoperative complications. Autofluorescence technology had shown some advantages in identifying parathyroid gland during operation, and its mechanism research and related equipment improvement should be focused in the future. ConclusionAutofluorescence technique is of great value in the identification of parathyroid glands in patients undergoing thyroidectomy or parathyroidectomy.
ObjectiveTo understand the methods of judging the blood supply of parathyroid during thyroidectomy at home and abroad in recent years. MethodThe literature on parathyroid blood supply was collected, the research progress was reviewed, and the advantages and disadvantages of related methods were analyzed. ResultsIn recent years, near-infrared fluorescence, laser speckle contrast imaging and other technologies had been applied. They showed better advantages as compared with naked eye observation. The research on parathyroid blood supply at home and abroad was still in its infancy, and more clinical samples and related equipment optimization were still needed. ConclusionFluorescence imaging technology has a certain auxiliary role in the judgment of intraoperative parathyroid blood supply and can reduce the incidence of hypoparathyroidism to a certain extent.
ObjectiveTo investigate the effectiveness of probe-based near infrared autofluorescence (AF) technology in the identification and functional protection of parathyroid gland (PG) during endoscopic total thyroidectomy. MethodsWe retrospectively collected the clinical data of 160 patients who underwent total thyroidectomy with bilateral central compartment lymph node dissection due to papillary thyroid carcinoma in Chongqing General Hospital from 1 July 2023 to 31 January 2024. Among them, 80 patients who used probe-based near infrared AF technology to identify the PGs were categorized as the AF group, 80 patients who used naked eye (NE) to identify the PGs were categorized as the NE group. The number of PGs identified, inadvertently removed, preserved in situ and autotransplanted, the incidence of postoperative hypoparathyroidism, and operative time were compared between the two groups. ResultsThe incidence of transient hypoparathyroidism was significantly lower in the AF group than that of the NE group [21.25% (17/80) vs. 43.75% (35/80), χ2=9.231, P=0.002], with no cases of permanent hypoparathyroidism in either group. The AF group had significantly more PGs identified and preserved in situ than the NE group (P<0.05) , but had significantly fewer PGs inadvertently removed and autotransplanted than the NE group (P<0.05). The AF group identified the first PG earlier than the NE group (4 min vs. 5 min, P<0.001). But there was no statistically difference in the operative time between the two groups (90 min vs. 94 min, P=0.052). ConclusionThe probe-based near infrared AF technology can help surgeons better identify and protect PGs during surgery, reducing the incidence of postoperative transient hypoparathyroidism.
Autofluorescence has great advantage on detecting premalignant lesions and early cancers which are not detectable by conventional white light endoscopy (WLE). In this review, the recent advances in autofluorescence for diagnosis of precancerous lesions and early cancers are presented. Varieties of endogenous fluorophores in biological tissues, the potential mechanisms of the autofluorescence differences between normal and abnormal tissues, the selection of light source and optimal excitation wavelengths, and effective algorithms for processing autofluorescence data are highlighted. Finally, the shortages and improvement directions of autofluorescence technique for the diagnosis of precancerous lesions and early cancers are briefly discussed.
ObjectiveTo systematically analyze the clinical features, multimodal imaging characteristics, and subtype distribution of pigmented paravenous chorioretinal atrophy (PPCRA). MethodsA retrospective case series. From January 2015 to June 2025, 19 patients (34 eyes) diagnosed with PPCRA at Department of Ophthalmology of Daping Hospital, Army Medical Center of PLA of Army Medical University were included in the study. Among them, there were 9 males and 10 females; the age was 52.0 (18, 59) years old. All affected eyes underwent fundus color photography examination; the numbers of eyes that underwent fundus autofluorescence (FAF), optical coherence tomography (OCT), fluorescein fundus angiography (FFA), and indocyanine green angiography (ICGA) were 17, 23, 15, and 10 respectively. Based on the results of fundus color photography and/or FAF examination, PPCRA was classified into perivenous subtype, focal subtype, and confluent subtype. All images were classified by two experienced ophthalmologists in a blinded and independent manner. The Fisher exact test was used to compare the differences in macular involvement rates among different types. ResultsAmong the 34 eyes, 16 eyes (47.1%, 16/34) were perivenous subtype, 13 eyes (38.2%, 13/34) had the confluent subtype, and 5 eyes (14.7%, 5/34) had the focal subtype. The consistency rate of the independent judgments by the two readers was 79.4% (27/34) (κ= 0.653, 95% confidence interval 0.427-0.878, P＜0.001), indicating a substantial consistency. Among the 23 eyes that underwent OCT examination, 12 eyes (52.2%, 12/23) had macular involvement, including 9 eyes (90.0%, 9/10) of the fusion type and 3 eyes (30.0%, 3/10) of the venous side type; no macular involvement was observed in the focal subtype. There was a statistically significant difference in the rate of macular involvement among different types (P=0.003). FAF typically showed paravenous band-like hypoautofluorescence with irregular rim hyperautofluorescence. FFA predominantly demonstrated transmission hyperfluorescence without leakage; venous leakage was noted in both eyes of one patient. ICGA commonly showed persistent paravenous hypofluorescence. OCT revealed attenuation or loss of the ellipsoid zone and interdigitation zone, with outer retinal thinning. In severely atrophic areas, OCT also showed reduced or absent reflectivity of the retinal pigment epithelium, together with choroidal thinning. ConclusionsThe perivenous subtype was the most common subtype of PPCRA. Macular involvement was associated with the confluent subtype, suggesting a potentially higher risk of macular structural involvement in this phenotype. Multimodal imaging can clearly present lesion features and is valuable for lesion assessment and follow-up.