Abstract

DO.08.08

Results of adjuvant topical interferon-alpha-2b treatment in epithelial tumors of the ocular surface

Niederdräing N., Fuchsluger T., Westekemper H., Schmitz K., Steuhl K.-P., Meller D.
Department of Ophthalmology, University Hospital Essen

Objective: Current therapeutical concepts for epithelial tumors of the ocular surface often show destructive aftereffects compromising visual acuity. Topical interferon-alpha-2b offers a gentle alternative to current strategies. This study evaluates results of the treatment of epithelial tumors of the ocular surface with topical interferon-alpha-2b eye drops.
Methods: In this noncomparative, prospective, interventional case series, nineteen patients with epithelial tumours of the ocular surface were included. Fifteen patients with a conjunctival intraepithelial neoplasia (CIN I°-III°) and 4 with a conjunctival papilloma were recruited. Four patients suffered from neurodermatitis, one patient from ocular cicatricial pemphigoid, one from rhabdomyosarcoma with earlier radiation, chemotherapy and enucleation. Nine CIN patients and four papilloma patients had no further medical history. After primary excision all affected eyes were treated with interferon (IFN)-alpha-2b eye drops five times daily over a period of 6 weeks (1 million IU/ml Intron A, Schering) and followed up closely. In case of assumed recurrence a biopsy was repeated. Average follow-up was 15±3 months.
Results: The recurrence rate in CIN patients was 26.6%. Interestingly all patients showing recurrence suffered from atopic dermatitis. Eleven patients remained without signs of recurrence. No patient developed invasive squamous carcinoma. Two of the 4 patients with papilloma developed a recurrent lesion.
Conclusions: The combination of excisional biopsy and topical interferon-alpha-2b application seems to be an effective and safe treatment for conjunctival intraepithelial neoplasia and papilloma. The prognosis seems to be associated with the presence or absence of atopic dermatitis. In this entity interferon treatment over six weeks seems to be too short. In conclusion, we prefer the combined treatment of excisional biopsy and topical interferon-alpha-2b treatment to more destructive approaches such as radiation and cryotherapy, or treatment with antimetabolites such as 5-fluorouracil or mitomycin C.

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