J Korean Ophthalmol Soc > Volume 58(2); 2017 > Article
Journal of the Korean Ophthalmological Society 2017;58(2):147-155.
DOI: https://doi.org/10.3341/jkos.2017.58.2.147    Published online February 15, 2017.
The Effectiveness of Topical Chemotherapy for the Primary Treatment of Ocular Surface Squamous Neoplasia.
Im Gyu Kim, Sung Yu, Gwang Ja Lee, Kyoo Won Lee, Young Jeung Park
Cheil Eye Hospital, Daegu, Korea. eyepark9@naver.com
안구표면 편평상피세포 암종의 일차 치료로 국소점안 화학요법의 효과
김임규⋅유 성⋅이광자⋅이규원⋅박영정
제일안과병원
Correspondence:  Young Jeung Park,
Email: eyepark9@naver.com
Received: 20 October 2016   • Revised: 13 December 2016   • Accepted: 26 January 2017
Abstract
PURPOSE
In the present study, the effectiveness of topical chemotherapy for the primary treatment of ocular surface squamous neoplasia (OSSN) was evaluated. METHODS: We enrolled 10 patients (10 eyes) diagnosed with OSSN who received both clinical examination and anterior segment optical coherence tomography (AS-OCT) imaging. The patients were administered topical 0.02% mitomycin-C (MMC) 4 times/day in the affected eye. The patients with MMC-resistant OSSN received topical 1% 5-fluorouracil (5-FU) 4 times/day. AS-OCT imaging was performed before and after the treatment. Clinical examination and AS-OCT were used to monitor the efficacy of topical chemotherapy, recurrence and side effects. RESULTS: The mean age of the 10 patients (8 males, 2 females) was 76.7 years. The proportion of complete remission resulting from topical treatment with MMC was 80.0% (8 eyes) and 20.0% (2 eyes) when 5-FU was changed to MMC. The average duration of complete remission was 4.3 weeks and the average duration of no recurrence was 17.5 months. The epithelial thickness of the lesions, measured using AS-OCT, significantly decreased from 315.0 µm (pretreatment) to 105.3 µm (after complete remission). Additionally, the epithelial lesion appeared normal after treatment. The most common side effect was conjunctival hyperemia (60.0%, 6 eyes), followed by ocular allergy (30.0%, 3 eyes), superficial punctate keratitis (30.0%, 3 eyes) and corneal erosion (20%, 2 eyes). No serious complications were reported. CONCLUSIONS: Topical chemotherapy is as effective and well tolerated as a primary treatment for OSSN. Additionally, AS-OCT is a useful noninvasive adjunctive tool in the diagnosis and management of OSSN.
Key Words: 5-fluorouracil;Mitomycin C;Ocular surface squamous neoplasia;Optical coherence tomography


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