Widespread Ocular Surface Squamous Neoplasia Treated with Topical Interferon Alpha-2b

Abstract

Purpose: To emphasize the importance of staging ocular surface squamous neoplasia when contemplating use of topical interferon alpha-2b alone. Cases: Two patients with 360 degrees of limbal involvement. Results: Two patients with in situ squamous cell carcinoma of the conjunctiva and clinical involvement of the entire limbus were treated with topical interferon alpha-2b. Thorough examination and multiple biopsies excluded invasive disease. The patients had complete response to therapy. Conclusion: Widespread intraepithelial squamous neoplasia involving the entire limbus can be successfully treated with topical therapies. Biopsy plays a role in excluding invasive disease. Interferon alpha-2b is a preferable agent to start with because it is well tolerated. Since long-term risks of recurrence are unknown, appropriate monitoring is essential.

Ocular surface squamous neoplasia with 360° limbal involvement: A comparative study of 130 patients

“…A high index of suspicion should therefore be kept for placoid lesions straddling the limbus in a circumferential fashion. On the other hand, involvement of entire limbus can also be seen with tumors with diffuse ocular surface involvement and large lesions [3][4][5] which was observed in 50% of the 360-OSSN tumors in this study (Fig. 2).…”

“…Few cases of 360-OSSN in published literature also show a similar pattern. 2,3,5,6 This nding supports the plausible role of limbal stem cell niche in origin and progression of OSSN. This wreath-like con guration, however, can be subtle with lesions reaching a height of as less as 1 mm.…”

“…1 Concept of cancer stem cells may also explain the tendency of OSSN to spread in a circumferential fashion along the limbus 1 sometimes involving entire 12 clock hours or 360°o f the limbus. [2][3][4][5][6] The present series attempts to describe the clinico-demographic pro le and outcomes of patients with 360-OSSN and compare them with SL-OSSN in order to identify cues for early diagnosis and appropriate management.…”

“…1 Though OSSN most often originates at the limbus, 1 few case reports (Table 1) have documented involvement of 360° of the limbus by the tumor (360-OSSN). [2][3][4][5][6] In addition, 360-OSSN poses a unique challenge in terms of management 7 with outcomes likely to be affected by the extent of disease as well as resultant damage to the limbal stem cells. The study of 360-OSSN, therefore, offers a unique opportunity in understanding the pattern of limbal involvement and hypothesize its potential course of progression.…”

Interferons and Eye Diseases

“…Некоторые исследователи рекомендуют использовать местный ИФН-α 2b в качестве первой линии терапии в случае интраэпителиальной неоплазии роговицы и конъюнктивы как более эффективный и безопасный по сравнению с другими методами лечения, такими как хирургическое иссечение и использование химиотерапевтических препаратов, которые могут вызывать тяжелую лимбальную недостаточность и другие побочные эффекты [41]. Как показывают некоторые работы, распространенная на весь лимб внутриэпителиальная плоскоклеточная неоплазия может быть успешно вылечена с помощью местной терапии ИФН-α 2b в дозировке 1 млн МЕ/мл 4 раза в день [42]. Другие исследования, однако, предполагают более высокие концентрации местного ИФН-α 2b, такие как 3 млн МЕ/мл 4 раза в день с продолжением терапии в течение 2-3 месяцев после клинического разрешения опухоли [51].…”