DIFFERENT MODALITIES IN THE MANAGEMENT OF OCULAR SURFACE SQUAMOUS NEOPLASIA

Purpose: To study the different modalities in the management of Ocular Surface SquamousNeoplasia(OSSN).Method: A prospective study of 30 cases of OSSN was undertaken. Based on patient factors andtumour size and characteristics , 20 patients underwent surgical excision with cryotherapy and 10patients were managed conservatively with topical interferon therapy. Patients were followed up for aperiod of nine months.Results: OSSN is more common in males (80%) with mean age of 55 years (range 30-76 years).Histopathology report of excision biopsy showed 6 benign dysplasia, 8 carcinoma in situ and 6invasive squamous carcinoma. Postoperative topical interferon reduced the risk of recurrence.Of the patients who underwent interferon therapy, complete resolution was seen in 6 cases.Conclusion : Management of OSSN requires adequate excision and regular follow up to monitor anyrecurrence. Although surgical excision is still the gold standard for OSSN treatment, topicalinterferon has revolutionised the management of OSSN. Pre and Post operative adjunctive therapyshould be considered to prevent recurrence.

Histopathological spectrum of ocular surface squamous neoplasia: A retrospective study of 776 lesions

Background: Ocular surface squamous neoplasia (OSSN) comprises neoplasm arising from the ocular surface, which includes conjunctiva, cornea, and limbus and ranges from mild dysplasia to invasive squamous cell carcinoma. Purpose: The aim of this work was to study the spectrum of OSSN based on histopathological analysis. Materials and Methods: This was a retrospective cross-sectional study comprising 776 histopathologically diagnosed cases of OSSN from January 2004 to December 2014. Results: The mean age of presentation of OSSN was 45 years (median, 45 years; 2 to 87 years) with male preponderance (74%). The most common age group of presentation was 41–60 years (n = 299; 39%). The most common type of OSSN was invasive squamous cell carcinoma seen in 50% (n = 383) eyes followed by severe dysplasia/carcinoma in situ in 31% (n = 250) eyes. Tumor infiltration at base was seen in 16% (n = 124), positive margins in 32% (n = 248), scleral infiltration in 14% (n = 109), intraocular extension in 3% (n = 23), and orbital extension in 4% (n = 26) eyes. OSSN was associated with actinic keratosis in 21% (n = 165) cases. Conclusion: Based on histopathology, invasive squamous cell carcinoma is the most common form of OSSN in the Asian Indian population.

Topical 002% Mitomycin C for management of primary corneal-conjunctival intraepithelial neoplasia as primary therapy: A long term follow up

Background: The corneal-conjunctival intraepithelial neoplasia (CCIN) is an ocular surface neoplasia commonly found among populations exposed to strong UV light. Although surgical excision is mainstay treatment, topical Mitomycin-C (MMC) 0.02% has been tried as a sole therapeutic treatment of non- invasive Ocular Surface Squamous Neoplasia (OSSN). Aim: The aim of this study was to report the long term outcome of treatment of non invasive ocular surface squamous neoplasia with topical Mitomycin C (0.02%) as primary therapy. Materials and methods: Total six eyes of six patients with CCIN were treated with topical mitomycin C (0.02%) alone as a sole therapy. All patients received topical MMC (0.02%) four times daily as a cycle therapy of two week ON and two week OFF for 12 weeks. The patients were followed up to two years. Results: All patients showed total cure with no recurrence during 2 years follow up period. Ocular irritation and mild conjunctival hyperemia were observed in 4 eyes during treatment with MMC. There were no serious complications noted at the end of the follow-up period. Conclusion: We concluded that Topical Mitomycin C (0.02%) may be used as a sole therapeutic treatment of non invasive Ocular surface squamous neoplasia with close on going follow-up.

Ocular Surface Squamous Neoplasia

PURPOSE: To assess the characteristics and treatments of ocular surface squamous neoplasms (OSSN). METHODS: We analyzed four representative cases of squamous neoplasms present on the ocular surface and discussed a new paradigm for the diagnosis and management of such lesions. CONCLUSIONS: Conjunctival and corneal tumors differentiated to squamous cells are rare. OSSN has various clinical appearances, and because OSSN itself is either malignant or has potential to become malignancy, precise discrimination and adequate treatment methods are necessary. We hope that the results from this study provide a basic source of information for diagnosing and treating OSSN.