Late Recurrences and the Necessity for Long-term Follow-up in Corneal and Conjunctival Intraepithelial Neoplasia

Tabin, Geoffrey; Levin, Samantha; Snibson, Grant R.; Loughnan, Michael; Taylor, Hugh R.

doi:10.1016/s0161-6420(97)30287-5

Cited by 198 publications

(178 citation statements)

References 17 publications

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“…O tratamento primário da neoplasia intraepitelial compreende as excisões cirúrgicas, associadas, em muitos casos, à crioterapia (3)(4)(5)(6) . Em casos de acometimento Figura 1: Fotografia em lâmpada de fenda do paciente nos diversos momentos de exame.…”

Section: Discussionunclassified

“…Pós-operatório: C -área da lesão corada por colírio de fluoresceína no primeiro dia após o procedimento; D -Aspecto totalmente epitelizado, sem sinais de recidiva, em fotografia red free, após 12 meses conjuntival, a técnica de Moh deve ser preferencialmente utilizada para a redução do risco de recorrência (5) . Os antineoplásicos têm sido utilizados como tratamento adjunto, com o objetivo de reduzir o alto índice de recorrência (4,5,9,(10)(11)(12)(13) e de evitar sucessivas abordagens cirúrgicas, prevenindo fibrose conjuntival e insuficiên-cia limbar (3,13) .…”

Section: Discussionunclassified

“…Apesar de a excisão cirúrgica ainda ser o tratamento de escolha para a neoplasia intraepitelial, a recorrência das lesões pode chegar a 56%, dependendo da abordagem empregada (3)(4)(5) . Em função disso, os agentes antineoplásicos têm sido cada vez mais utilizados como terapia adjunta (5,9,13) .…”

Section: Discussionunclassified

“…No presente trabalho, os autores descrevem um caso de displasia intraepitelial isolada de córnea, tratada através de excisão cirúrgica, com confirmação histológica e resultado negativo de hibridização de DNA para HPV. (1)(2)(3)(4) . São lesões com baixo risco de malignidade e de lenta progressão (2,4) , que têm como fatores de risco o papilomavírus humano (HPV), exposição a radiação ultravioleta e, possivelmente, infecção pelo HIV (2,5) .…”

Section: Introductionunclassified

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Captura híbrida negativa em displasia intraepitelial isolada de córnea

Martin

Filho

Odashiro³

et al. 2010

Rev. bras.oftalmol.

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RESUMOAs displasias intraepiteliais de córnea correspondem a lesões de baixo risco de malignidade, dentro do espectro das neoplasias intraepiteliais da superfície ocular. Essas displasias se apresentam como áreas leucoplásicas e têm como um dos principais fatores de risco o papilomavírus humano (HPV). No presente trabalho, os autores descrevem um caso de displasia intraepitelial isolada de córnea, tratada através de excisão cirúrgica, com confirmação histológica e resultado negativo de hibridização de DNA para HPV.

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Section: Discussionunclassified

Section: Introductionunclassified

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Captura híbrida negativa em displasia intraepitelial isolada de córnea

Martin

Filho

Odashiro³

et al. 2010

Rev. bras.oftalmol.

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“…This method has a recurrence rate of 30-40%. [5][6][7][8] This high recurrence rate can be explained by the inadequate surgical margins and small tumour remnants, which might remain after excision. 7 Thus, the positive excision margin at the time of surgery was suggested as the most important factor in predicting recurrence.…”

Section: Introductionmentioning

confidence: 99%

Excision and cryosurgery in the treatment of conjunctival malignant epithelial tumours

Peksayar

Altan-Yaycıoğlu

Onal

2003

Eye

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Purpose To evaluate the long-term results of combined treatment with excision and cryosurgery for malignant epithelial tumours of the conjunctiva. Methods We retrospectively reviewed the medical records of patients diagnosed with conjunctival malignant epithelial tumours and treated with excision and cryosurgery between 1980 and 1998. The demographic features of the patients, characteristics of the tumours, and the peculiarities of the recurrences were recorded. The SPSS V 9.05 computed program was used for the statistical analysis of the results. Kaplan-Meier plots were used to determine the recurrence-free survival, and the logrank test was used to compare the recurrences according to histological classification. Results A total of 55 subjects (57 eyes), 19 female and 36 male, were included in the study. Their ages ranged between 15 and 82 years (mean 55714 years). Histological diagnosis was conjunctival intraepithelial neoplasia (CIN) in 26 (46%) and invasive squamous cell carcinoma (SCC) of the conjunctiva in 31 eyes (54%). All eyes were treated with excision and cryosurgery with nitrous oxide probe. During the follow-up period of 6 months to 15 years, seven (12.3%) recurrences were observed. The success rate for patients with CIN and invasive SCC was 88.5 and 87.1%, respectively. There was no difference for recurrence rates between CIN and invasive SCC groups according to logrank test (P ¼ 0.68). Conclusions Over the long-term follow-up, cryosurgery following excision is a successful method in the treatment of conjunctival intraepithelial tumours and invasive squamous cell carcinoma of conjunctiva with favourable outcome and minimal complications.

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Conjunctival Lesion in a Patient With Ocular Graft-vs-Host Disease

2017

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A 67-year-old man presented with intermittent ocular irritation, discharge, and blurry vision in his left eye. He had a history of chronic lymphocytic leukemia for which he had received allogeneic bone marrow transplantation; his course was complicated by extensive graft-vs-host disease including ocular manifestations. His graft-vs-host disease was treated with systemic tacrolimus. He also had a history of herpes simplex keratitis with fungal infection in the right eye that led to corneal perforation requiring penetrating keratoplasty. His best-corrected visual acuities were 20/125 OD and 20/60 OS.Slitlamp examination of the right eye revealed eyelid margin hyperemia, penetrating keratoplasty graft in place, a deep and quiet anterior chamber, a normal iris, and posterior chamber intraocular lens. Examination of the left eye revealed eyelid margin hyperemia, an apparent soft tissue lesion on the palpebral conjunctiva of the left lower eyelid, inferior bulbar conjunctival injection, a small paracentral anterior stromal scar, a deep and quiet anterior chamber, a normal iris, and posterior chamber intraocular lens. The conjunctival lesion had vascular and papilliform elements (Figure ) and had not been noted on a routine examination 6 months prior. Figure. Clinical photograph showing a soft-tissue lesion on the palpebral conjunctiva of the left lower eyelid, accompanied by inferior bulbar conjunctival injection. WHAT WOULD YOU DO NEXT? A. Perform time-domain anterior segment optical coherence tomography B. Observe the patient C. Perform a biopsy of the lesion D. Obtain a culture of the lesion Clinical Review & Education

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Late Recurrences and the Necessity for Long-term Follow-up in Corneal and Conjunctival Intraepithelial Neoplasia

Cited by 198 publications

References 17 publications

Captura híbrida negativa em displasia intraepitelial isolada de córnea

Captura híbrida negativa em displasia intraepitelial isolada de córnea

Excision and cryosurgery in the treatment of conjunctival malignant epithelial tumours

Conjunctival Lesion in a Patient With Ocular Graft-vs-Host Disease

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