Topical 1% 5-fluorouracil eye drops as primary treatment for ocular surface squamous neoplasia: Long-term follow-up study

Wylęgała, Adam; Sripawadkul, Wathanee; Zein, Mike; Alvarez, Osmel P.; Bayyat, Ghada Al; Karp, Carol L.

doi:10.1016/j.jtos.2022.12.002

Cited by 8 publications

(3 citation statements)

References 44 publications

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“…This re ects the relatively quicker time to resolution when compared to the published literature reporting mean duration to resolution as 4-6 months. 16,19 This could be related to referral bias in tertiary health care centers versus early diagnosis of smaller lesions in a rural setup.…”

Section: Discussionmentioning

confidence: 99%

Treatment of ocular surface squamous neoplasia in an Indian rural facility: A study of 38 eyes

Agarwal,

Ghose,

Rathi

et al. 2024

Preprint

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Purpose To report the demographic profile, clinical presentation, and management outcomes of ocular surface squamous neoplasia (OSSN) treated with primary topical chemotherapy in a limited resource secondary eye care facility in rural parts of South India. Methods Retrospective interventional study of 38 eyes of 37 patients with OSSN treated with topical 1% 5-Fluoro uracil (5-FU), over a period of two years. Results The median age at presentation with OSSN was 44 years (mean, 46 years; range 13 to 74 years). Majority (76%) were males. The most common morphological variant was placoid OSSN (18, 47%). Limbus was the most common epicenter (31, 82%). Corneal OSSN was the most initially misdiagnosed variant (n = 3). Of the 38 eyes receiving one week on and 3-weeks off cycles of 5-FU regimen, complete tumor resolution was achieved in 36 (95%) eyes. The median number of topical 5-FU cycles for tumor resolution was 2 (mean, 2; range, 1 to 4). Over a median follow-up period of 5 months (mean, 6 months; range, 1 to 27 months), tumor recurrence was noted in 3 eyes (8%), of which one case had xeroderma pigmentosum with bilateral multifocal recurrence. Complication rate was 5% (n = 2), which included transient conjunctival hyperemia (n = 1), and bacterial keratitis (n = 1) which resolved with fortified antibiotics. Conclusion Primary chemotherapy with topical 1% 5-FU is a safe and effective management modality for OSSN at limited resource settings in rural India.

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Section: Discussionmentioning

confidence: 99%

Treatment of ocular surface squamous neoplasia in an Indian rural facility: A study of 38 eyes

Agarwal,

Ghose,

Rathi

et al. 2024

Preprint

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“…We have previously shown that 5FU has demonstrated comparable rates of resolution in the treatment of OSSN and lower cost but carries a more significant side-effect profile. 10,12 Finally, the online link to access the survey was provided during presentations at academic meetings; thus, an accurate response rate for eligible participants is unable to be calculated.…”

Section: Discussionmentioning

confidence: 99%

“…8 Benefits of 5FU include highresolution rates (82%-100%) and low recurrence (10%-14%) frequencies. [9][10][11][12] IFN, a protein with antiproliferative, immunomodulatory, and antiviral effects, 13 was first used against OSSN in 1994 14 and has since demonstrated efficacy as both topical eye drop and perilesional injection. 15,16 Benefits of IFN include high-resolution rates (75%-100%) and low recurrence (0%-25%) frequencies.…”

mentioning

confidence: 99%

Ocular Surface Squamous Neoplasia: Changes in the Standard of Care 2003 to 2022

Greenfield,

Cohen,

Galor

et al. 2024

Cornea

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Purpose: The aim of this review was to elucidate treatment preferences for ocular surface squamous neoplasia and to examine the changes in treatment modalities over the past 2 decades. Methods: An electronic survey was distributed to members of The Cornea Society, Ocular Microbiology and Immunology Group, and 4 international corneal specialist listservs. Questions examined medical and surgical treatment preferences, and results were compared with surveys administered in 2003 and 2012. Results: A total of 285 individuals responded to the survey; 90% of respondents were self-classified as corneal specialists. Seventy-three percent reported using primary topical monotherapy to treat ocular surface squamous neoplasia as compared with 58% in 2012 (P = 0.008). Compared with 2003, the percentage use of topical interferon significantly increased (P < 0.0001) from 14% to 55%, 5-fluorouracil increased (P < 0.0001) from 5% to 23%, and mitomycin C decreased (P < 0.0001) from 76% to 19% as a primary monotherapy. The frequency of performing excision without the use of postoperative adjunctive medical therapy decreased significantly (P < 0.0001), from 66% to 26% for lesions <2 mm, 64% to 12% for lesions between 2 and 8 mm, and 47% to 5% for lesions >8 mm from 2003 to 2022. More clinicians initiated topical immuno/chemotherapy without performing a biopsy as compared to 2003 (31% vs. 11%, P < 0.0001). Conclusions: These results demonstrate a paradigm shift in the management of ocular surface squamous neoplasia. The use of primary medical therapy as a first approach has significantly increased, with a reduction in the frequency of performing surgical excision alone.

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Efficacy of topical 5-Fluorouracil in the management of ocular surface squamous neoplasia: a study of 101 eyes

Bakal,

Molugu,

Machakuri

et al. 2024

Int Ophthalmol

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Topical 1% 5-fluorouracil eye drops as primary treatment for ocular surface squamous neoplasia: Long-term follow-up study

Cited by 8 publications

References 44 publications

Treatment of ocular surface squamous neoplasia in an Indian rural facility: A study of 38 eyes

Treatment of ocular surface squamous neoplasia in an Indian rural facility: A study of 38 eyes

Ocular Surface Squamous Neoplasia: Changes in the Standard of Care 2003 to 2022

Efficacy of topical 5-Fluorouracil in the management of ocular surface squamous neoplasia: a study of 101 eyes

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