Treatment of Ocular Surface Squamous Neoplasia with Interferon Alpha-2b
Purpose: To study the efficacy and safety and of Interferon (IFN) alpha 2b for Ocular Surface Squamous Neoplasia (OSSN).
Study Design: Non - Comparative Interventional Study.
Place of Study: Mayo Hospital Lahore, Lahore General Hospital, Armed Forces Institute of Ophthalmology, Rawalpindi, Pakistan
Duration of Study: study was conducted between the period of October 2010 to August 2016.
Material and methods: Patients with suspected conjunctival growth underwent incisional biopsy after admission from out patient department. After confirming the diagnosis of Ocular Surface Squamous Neoplasia (OSSN), on Histopathology, case was inducted in the study. Intralesional / peri-lesional Interferon(IFN) Alpha-2b was given to the patients weekly along with interferon Alpha-2b topical drops four times daily, for Three 03 months. These patients were followed in Out Patient Department of respective hospitals and examined. For resolution or recurrence of lesion for at least three (03) months. And final results were compiled.
Results: Study was conducted at Mayo Hospital Lahore, Armed Force institute of Ophthalmology, Rawalpindi and Lahore General Hospital, Lahore. Total Sample size of 90 (Ninety) Patients is estimated by using 95% confidence level, 10% absolute precision with expected percentage of Ocular surface squamous neoplasia as 91.6%.
n= (Z1-α/2)2 X P X q / d2
Z1-α2 = Confidence level 95% = 1.96
P = Prevalence 91.6%
d= Absolute precision 10%
Out of these Twenty-nine, 29 were females and Fifty Nine, 59 were male patients. Non-Probability consecutive sampling was done. All patients tolerated and responded well to the treatment. There was recurrence in Eight 8 eyes.
Conclusion: For the management of Ocular surface squamous Neoplasia IFN alpha 2 b is safe and effective choice with low recurrence rates.
2. Basti, Surendra MD; Macsai, Marian S : Ocular Surface Squamous Neoplasia: A Review. Cornea. October 2003; 22(7): 687-704.
3. Ng J, Coroneo MT, Wakefield D, Di Girolamo N: Ultraviolet radiation and the role of matrix metalloproteinases in the pathogenesis of ocular surface squamous neoplasia. Invest Ophthalmol Vis Sci. 2008 Dec;49(12):5295-306.
4. Sen S, Sharma A, Panda A. Immunohistochemical localization of human papilloma virus in conjunctival neoplasias: a retrospective study. 1. Indian J Ophthalmol 2007;55(5):361–3.
5. C Chen, D Louis, T Dodd,J Muecke: Mitomycin C as an adjunct in the treatment of localised ocular surface squamous neoplasia.Br J Ophthalmol. 2004 January; 88(1): 17–18.
6. Di Pascuale, Mario A, Espana, Edgar M, Tseng, Scheffer C.A Case of Conjunctiva-Cornea Intraepithelial Neoplasia Successfully Treated with Topical Mitomycin C and Interferon Alfa-2b in Cycles; Cornea. January 2004:23(1)89-92.
7. Karp CL, Galor A, Chhabra S, Barnes SD, Alfonso EC.Subconjunctival/perilesional recombinant interferon α2b for ocular surface squamous neoplasia: a 10-year review. Ophthalmology. 2010;117(12):2241-6.
8. Kobayashi A, Yoshita T, Uchiyama K, et al. Successful management of conjunctival intraepithelial neoplasia by interferon alpha-2b. Jpn J Ophthalmol. 2002;46(2):215–7.
9. Lee GA, Hirst LW. Ocular surface squamous neoplasia. Surv Ophthalmol. 1995;39(6):429-450
10. Yang J, Foster CS: Squamous cell carcinoma of the conjunctiva. Int Ophthalmol Clin. 1997; 37(4).73-84
11. Fraunfelder FT, Wingfield D. Management of intraepithelial conjunctival tumors and squamous cell carcinomas. Am J Ophthalmol 1983;95(3):359-63.
12. Daniell M, Maini R, Tole D. Use of mitomycin C in the treatment of corneal conjunctival intraepithelial neoplasia. Clin Experiment Ophthalmol. 2002;30(2):94-8.
13. McKelvie PA, Daniell M, McNab A, Loughnan M, Santamaria JD. Squamous cell carcinoma of the conjunctiva: a series of 26 cases. Br J Ophthalmol. 2002;86(2):168–173.
14. Siddiqui ZK, Mahmood K, Lateef Q, Haider WA. Management of ocular surface squamous cell carcinoma at Lahore General Hospital, Pakistan. Pak PG Med Jr 2009;20(1):30-31.
15. Boehm MD, Huang AJ. Treatment of recurrent corneal and conjunctival intraepithelial neoplasia with topical interferon alfa 2b. Ophthalmology 2004;111(9):1755-61.
16. SiedleckiA.N. , Tapp.S, Tosteson.A.N. , Larson.R.J, Karp.C.L. , Lietman T. Zegan ME.Surgery versus interferon Alpha-2b treatment strategies for ocular surface squamous neoplasia: a literature-based decision analysis. Cornea. 2016;35(5):613-618.
17. Kim HJ, Shields CL, Shah SU, Kaliki S, Lally SE. Giant ocular surface squamous neoplasia managed with interferon alpha-2b as immunotherapy or immunoreduction. Ophthalmology. 2012;119(5):938–44.
18. Galor A, Karp CL, Chhabra S, Barnes S, Alfonso EC. Topical interferon alpha 2b eye-drops for treatment of ocular surface squamous neoplasia: A dose comparison study. Br J Ophthalmol. 2010;94(5):551–4.
19. Mercado CL, Pole C, Wong J, Batlle JF, Roque F. ShaikhN. Murillo JC. Galor A. Karp CL.Surgical versus medical treatment for ocular surface squamous neoplasia: A quality of life comparison. The ocular Surface. 2019;17(1):60-63
20. McClellan AJ, McClellan AL, Pezon CF, Karp CL, Feuer W, Galor A. The epidemiology of ocular surface squamous neoplasia in a Veterans Affairs population. Cornea. 2013;32(10):1354.