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Christine E Greer, Jesse Berry; A Sticky Situation. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1789.
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© ARVO (1962-2015); The Authors (2016-present)
Ocular surface squamous neoplasia (OSSN) is the most common non pigmented ocular neoplasm, encompassing a spectrum of conjunctival and corneal epithelial neoplastic tumors, from conjunctival intraepithelial neoplasia (CIN) to squamous cell carcinoma. In recent years, treatment has shifted away from traditional therapies such as surgical excision and cryotherapy in favor of medical management with topical chemotherapeutic agents. Primary medical therapy with topical chemotherapeutic agents have demonstrated resolutions rates between 80-100% (Karp 2010) and recurrence rates consistently less than 20% (Karp 2010). We report a case of a 73 year old Hispanic female with OSSN with invasion to the eyelid margin (grade T3) in which the ocular surface was treated with good response to topical 5-FU with residual lid margin disease that responded to interferon injections. To the author's knowledge, this is the first published report of lid involving OSSN lid treated with IFN injections.
Given extent of disease, chemoreduction with topical 5-FU was initiated. The patient underwent treatment for two weeks, followed by a two week holiday. The patient was treated with a total of six weeks of 5-FU. Ultimately, the ocular surface disease resolved, however, a three mm diameter canalicular involving lower lid lesion remained. The decision was made to treat with interferon alpha-2-b (IFN) injections.
The patient underwent four series of weekly IFN injections (intinally 3000 U/0.5ml and 8000U/0.5 ml thereafter) before clinical resolution confirmed by anterior segment optical coherence tomography.
To our knowledge this is the first reported case of OSSN of the lid treated with IFN injections.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
External slit lamp photograph of the right eye depicting extensive ocular surface neoplasia, with extension to the lower lid.
External slit lamp photograph of the right eye demonstrating a residual lower lid lesion, despite fully treated ocular surface disease
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