Elsevier

Ophthalmology

Volume 115, Issue 8, August 2008, Pages 1291-1296.e1
Ophthalmology

Original article
Long-term Follow-up of Conjunctival and Corneal Intraepithelial Neoplasia Treated with Topical Interferon Alfa-2b

https://doi.org/10.1016/j.ophtha.2007.10.039Get rights and content

Objective

To evaluate the long-term recurrence rate (>1 year) of conjunctival and corneal intraepithelial neoplasia (CIN) treated with topical interferon alfa-2b.

Design

Retrospective, noncomparative, interventional case series.

Participants

Twenty-eight eyes of 26 patients from 2 institutions, treated between April 1997 and June 2005, with CIN lesions utilized topical interferon alfa-2b drops 4 times daily until clinical resolution was achieved.

Methods

Patients' charts and clinical photographs were reviewed, and data were analyzed.

Main Outcome Measures

All eyes were monitored for the possibility of recurrence with a minimum of 1-year follow-up from the time of documented clinical resolution.

Results

Complete clinical resolution of the CIN lesions was achieved in 27 of the 28 eyes treated (96.4%). One of the 28 eyes treated (3.6%) had only a partial response to treatment. For the 27 eyes with complete response, resolution occurred after a median of 2.0 months (range, 10 days–15 months). Eyes were treated for a median of 3.2 months (range, 1–15). Median follow-up after clinical resolution (tumor-free period) was 42.4 months (range, 14–89). One eye of the 27 analyzed (3.7%) experienced a recurrence. Side effects of treatment were limited to mild conjunctival hyperemia and follicular conjunctivitis in 3 patients (12%). In all cases, there was total resolution of the side effects within 1 month after cessation of the medication.

Conclusions

In this group of patients with CIN lesions observed for >1 year, topical interferon alfa-2b was effective in treating lesions with minimal self-limited side effects.

Section snippets

Subjects and Methods

Twenty-eight eyes of 26 patients with CIN, 15 eyes treated in a private practice (BAS) and 13 eyes treated at the Bascom Palmer Eye Institute (CLK), were included in this study. Twenty-one of the 28 lesions were diagnosed histologically. Clinical diagnosis8, 9 of the other 7 lesions was made by an ophthalmologist who completed a cornea/external disease fellowship.

A retrospective review of all patients treated with topical interferon alfa-2b between April 1997 and June 2005 was conducted. A

Results

Twenty-eight eyes of 26 CIN patients were treated with topical interferon alfa-2b drops. Complete clinical resolution of the CIN lesions was achieved in 27 of the 28 eyes treated (96.4%). Figure 1 demonstrates slit-lamp photographs of CIN lesions before treatment with topical interferon alfa-2b and comparisons of the same eye after clinical resolution. One of the 28 eyes treated (3.6%) had only a partial response to treatment and could not be included in the statistical analysis.

The

Discussion

Conjunctival and corneal intraepithelial neoplasia is the most common neoplasm of the ocular surface. The traditional treatment has been wide local surgical excision with adjunctive cryotherapy to the surgical margins in a double freeze/slow thaw technique. Pathologic examination of the excised margins had been important because many lesions were incompletely excised due to diffuse lateral growth. These were associated with a higher incidence of recurrence after surgery.34 Conjunctival and

References (35)

Cited by (0)

Manuscript no. 2007-396.

The authors have no financial interest in any of the products or instruments used in the study.

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