Impression cytology following mitomycin C therapy for ocular surface squamous neoplasia
Penelope A McKelviea, Mark Daniellb
a Department of
Anatomical Pathology, St Vincent's Hospital, Melbourne, Victoria,
Australia, b Royal Victorian
Eye and Ear Hospital, East Melbourne, Victoria, Australia
Correspondence to: Penelope McKelvie, Anatomical Pathology, St Vincent's Hospital, 41 Victoria Parade, Fitzroy, Vic 3065, Australia mckelvpa.svhm.org.au
Accepted for publication 27 March 2001
BACKGROUND/AIMS
Topical
mitomycin C (MMC) therapy has been used for treatment of ocular surface
squamous neoplasia (OSSN) since 1994. Relatively few studies have
reported the cellular changes in ocular surface following MMC.
METHODSImpression
cytology was studied in four patients with ocular surface squamous
neoplasia, either primary or recurrence after previous excisional
biopsy. The authors studied samples obtained using Millipore filters at
intervals between 4 and 17 weeks after commencement of MMC, and
compared them with pretreatment cytology.
RESULTSMMC induced
changes of cytomegaly, cytoplasmic vacuolation, nucleomegaly
with nuclear wrinkling, and binucleation or multinucleation were seen
in some cells in all samples. However, nuclear/cytoplasmic (N/C) ratio
in these enlarged cells was normal. These changes mimicked those seen
following radiation therapy in uterine cervix. Changes of increased
nuclear and cell size with increased N/C ratio were seen in some
dysplastic cells. The predominant form of cell death was apoptosis with
fewer cells showing necrosis.
CONCLUSIONSMMC
appears to produce cell death in OSSN by apoptosis and necrosis.
Cellular changes related to MMC mimic those caused by radiation-cytomegaly, nucleomegaly, and vacuolation. MMC related changes may persist in ocular surface epithelium for at least 8 months
following MMC therapy.
© 2001 by British Journal of Ophthalmology
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This article has been cited by other articles:
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Chen, C, Louis, D, Dodd, T, Muecke, J
(2004). Mitomycin C as an adjunct in the treatment of localised ocular surface squamous neoplasia. Br. J. Ophthalmol.
88: 17-18
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