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R. W. Sedeek, K. J. Chin, P. T. Finger; Topical Interferon Alpha Eye Drops for PAM With Atypia-Conjunctival Melanoma Complex. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5221.
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To report the first use of topical interferon alpha-2b (INFa2b) in the treatment of conjunctival and corneal melanoma.
Retrospective case-series review of medical records and slit lamp photographs of patients with biopsy proven primary acquired melanosis (PAM) with atypia and conjunctival malignant melanoma complex (CMM) who received topical INFa2b as part of treatment for primary or recurrent disease. Topical interferon chemotherapy involved placing one drop of INFa2b (1 million units/cc) into the superior fornix four times a day for up to three months duration. Lower eyelid punctal plugs were placed to limit systemic absorption.
Five consecutive patients with PAM or CMM complex including those with corneal extension AJCC-UICC Stages T2 (n = 3), T3 (n=2) were N0, M0 by total body 18 FDG PET/CT with fusion. Two patients had recurrent corneal tumors eight to thirteen months after local excision, cryotherapy and topical mitomyicn C (MMC). Two months after they had been started on topical INFa2b, the lesions regressed with no side effects.Two patients who couldn't tolerate topical MMC were switched to topical INFa2b with minimal side effects and have no signs of recurrence for a mean of eleven months.One patient had recurrent tumor despite multiple local excisions, cryotherapies, topical MMC and topical INFa2b. This melanoma did not regress in response to the topical INFa2b and he did not tolerate treatment due to keratoconjunctivitis. None of the five patients had any systemic side effects related to our method of topical INFa2b therapy.
This study reveals the first evidence that PAM with atypia as well as malignant melanoma of the conjunctiva and cornea responds to treatment with topical interferon alpha-2b. These preliminary results suggest that a larger scale, more long term study is needed to evaluate the long-term efficacy and safety of topical INFa2b for PAM and CMM.
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