Conjunctival/corneal intraepithelial neoplasia: case series review

Session Details

Session Title: Presented Poster Session: Ocular Pathologies

Venue: Poster Village: Pod 3

First Author: : M.Ruiz Del Tiempo SPAIN

Co Author(s): :    R. Yela Delgado   L. Ibares Frias   C. Colliga Jimenez   A. Escalona Lozano   J. Da Saude Lourenco   B. Garcia-Valcarcel        

Abstract Details

Purpose:

The aim of this study was to review a series of 7 cases of conjunctival/corneal intraepithelial neoplasia (CIN) in order to evaluate the efficacy and safety of the different adjuvant treatment modalities.

Setting:

All the patients are followed up in the Ocular Surface & Cornea Department at Hospital General Universitario Gregorio Marañon, Madrid, Spain.

Methods:

Review of the clinical history and additional documentation of 7 cases with a lesion suspicious for CIN treated initially with surgical resection and in a second time with adjuvant therapy. All patients were followed up weekly with a complete ophthalmological evaluation including visual acuity, biomicroscopy, tonometry, fundoscopic analysis and serial photography. The efficacy of the treatment was determined by the reduction of the existing lesion.

Results:

All 7 cases were treated with surgical resection initially, 5 of which were confirmed histologically to represent CIN and required adjuvant treatment. Three cases were exclusively treated with topical interpheron alpha 2 beta (IFN α-2b) and two patients required additional mitomycin C (MMC) 0,02% due to the absence of complete response to IFN α-2b alone. These two patients developed symptomatic intolerance to the treatment. In one of these patients the lesion persisted, hence a subconjunctival IFN α-2b injection and further surgical exeresis was carried out, obtaining complete remission. All patients are in complete remission of the lesions to day.

Conclusions:

Surgical resection is the gold-standard treatment for CIN, yielding histological confirmation of the diagnosis. However, extensive lesions with limbar involvement or surgical margin infiltration are factors involved in high recurrence rates if adjuvant therapies are not applied. Topical MMC is an effective option, however the adverse events in relation to ocular surface disease require interruption of treatment in many cases. Topical or subconjunctival IFN α-2b represent a good alternative treatment in cases of recurrence or selected cases such as intolerance to MMC, being a high economic cost its main limitation.

Financial Disclosure:

None