Abstract
Purpose :
To determine and compare the frequency of resolution and time of recurrence of NESO among patients treated with Interferon alfa-2b and those treated with 5-fluorouracil.
Methods :
Design: Experimental, Randomized
Patients with clinical suspicion of NESO underwent exfoliative cytology and anterior segment high resolution OCT (HR SA-OCT) to confirm the diagnosis. Once the diagnosis was confirmed, they were randomly assigned to the Interferon alfa-2b or 5-Fluorouracil group and were treated with these drugs. The treatment response was monitored by clinical photographs and by HR SA-OCT on a monthly basis until clinical and tomographic resolution. If adverse effects occurred, topical lubricants and short cycles of prednisolone were indicated. Risk factors for NESO as history of skin cancer, smoking and sun exposure were documented. The main outcome measures were the percentage of clinical resolution, the time that it occurred and the percentage of NESO recurrence with each treatment modality. As a secondary result, the percentage of adverse effects will be determined.
Results :
22 eyes were included, 50% were female and in 54.4% the lesion was in the right eye. 31.80% of the patients had positive smoking status and 63.50% had significant positive sun exposure. None of the included patients had a history of skin cancer. 45.4% of the lesions were gelatinous, 27.2% were leukoplakic, and 27.2% were papilliform. 50% of the patients were included in the 5-FU group and 50% in the interferon IFN-a2b group, of which 18% presented burning, 13% conjunctival hyperemia and 9% pruritus without significant difference between both groups (p >0.05).
The average initial measurements of the lesions were 5344.9 microns in base and 652 microns in height by OCT, with a statistically significant reduction at 3 months of follow-up in 95% of the lesions (p<0.05), with no difference between both groups of treatment.
Although more adverse effects have been reported with 5-FU treatment such as pain, conjunctival hyperemia, chemosis and palpabral edema, they have not been observed in this study.
Conclusions :
Topical chemotherapy with 5-FU and IFN alfa-2b is effective for the treatment of NESO with no difference between both medications. HR SA-OCT is a useful tool for the detection and monitoring of patients undergoing treatment.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.