Autophagy detection using monodansylcadaverine and propidium iodide co-staining 4 h following photodynamic therapy (PDT) in the (A) untreated control group, (B) metformin alone group, (C) 5-ALA-PDT (5 J/cm2) group and (D) 5-ALA-PDT (5 J/cm2) with metformin group. The untreated control group exhibited few autophagosomes. The 5-ALA-PDT group and the 5-ALA-PDT with metformin group exhibited increased numbers of autophagosomes. Magnification, ×200. Yellow arrows indicate autophagosomes. 5-ALA, 5-aminolevulinic acid; PDT, photodynamic therapy.