Safety and efficacy of topical interferon alpha 2B and mitomycin C for localized conjunctival intraepithelial neoplasia: long-term report of their pharmacological safety and efficacy.

PURPOSE: Ocular surface squamous neoplasia (OSSN) comprises a wide spectrum of squamous tumors, from which corneal/conjunctival intraepithelial neoplasia (CIN) is the most common one. The classic treatment is complete excision, but recurrence rates are high. Antineoplastic drugs such as mitomycin C (MMC) and interferon alpha 2b (IFNα2b) have been used as adjuvants or as primary treatment. To evaluate the efficacy and safety of topical IFNα2b and MMC in patients with CIN, a phase IIb double-blind clinical trial was performed. METHODS: Patients diagnosed with localized CIN were evaluated by slit lamp and impression cytology and were randomly given MMC 0.04% or INF2b (1 million IU/mL) 4 times daily until neoplasia resolution. Time of resolution and frequency of adverse effects were analyzed to determine the pharmacological efficacy and safety of both medications. RESULTS: Seventeen patients were included. Nine patients were treated with MMC and 8 with IFNα2b. All patients responded to treatment. The resolution time in days was 59.11 ± 24.02 in patients treated with MMC and 143.50 ± 47.181 in those treated with IFNα2b (p < 0.001). In the MMC group, one recurrence was reported (11%). There were no recurrences at 2 years of follow-up in the IFNα2b group. Regarding adverse effects, one or more mild adverse reaction occurred in 77% of patients managed with MMC and in 50% of patients managed with IFNα2b (p > 0.05). No serious adverse effects were reported. CONCLUSIONS: Topical chemotherapy with MMC and IFNα2b demonstrate pharmacological safety and efficacy. Therefore, these drugs could be considered as primary therapies for localized CIN .

Differentiation in retinoblastoma and histopathological risk factors in Mexico.

PURPOSE: To describe the relationship between retinoblastoma differentiation, histopathological risk factors, age at enucleation, laterality, and genetic type (hereditary or sporadic) in a series of enucleated eyes in a referral hospital. The criteria used in other studies to classify retinoblastoma differentiation are discussed. METHODS: The authors retrospectively studied histopathological preparations of eyes with retinoblastoma treated with primary enucleation. Tumors were classified as well differentiated, undifferentiated, and moderately differentiated. Patient age at enucleation, laterality of disease, genetic form (hereditary or sporadic), and presence of histopathological risk factors (massive choroidal infiltration, postlaminar optic nerve invasion, tumor in optic nerve cut, scleral invasion, and involvement of orbital soft tissues) were analyzed. The chi-square test was used for categorical variables and analysis of variance for test mean differences. RESULTS: Histopathological risk factors were present in 23 (36%) of 63 eyes. Moderately differentiated tumors occurred at advanced ages and were more frequently associated with histopathological risk factors. CONCLUSIONS: A consensus is needed to establish the histopathological criteria of retinoblastoma differentiation. The value of rosettes as a marker of cell differentiation should be reviewed.[J Pediatr Ophthalmol Strabismus 2013;50(3):174-177.].