tretinoin and Conjunctival-Neoplasms

To evaluate the long-term follow-up of recurrent conjunctival and corneal intraepithelial neoplasia (CCIN) treated with combination topical interferon alfa-2b and retinoic acid (I/RA).. Our study represents a retrospective observational interventional series of 82 eyes from 82 patients from a single institution, reviewed for CCIN. All were administered topical interferon alfa-2b 1 million IU/mL QID and retinoic acid 0.01% every other day. Patients had been diagnosed by biopsy. A Kaplan-Meier survival analysis, Wilcoxon signed-rank test and a multivariate logistic regression were statistical tests used to correlate recurrence with patient and tumor variables.. 79 eyes assessed for CCIN diagnoses and treated with I/RA achieved tumor resolution. The median tumor-free follow-up was ~109.1 months with a median time to resolution being ~2.8 months. Our median treatment duration was ~11.3 months. The greatest difference in the mean total residual tumor size was identified between Months 0-1 [-7.63 mm. Combination I/RA was effective in treating CCIN lesions with few transient side effects. The combination of retinoids and interferons may represent a viable topical therapeutic agent with an extended tumor-free follow-up and a large proportion of our study's patients achieving >10 year's tumor-free follow-up. Our treatment duration is long, but by cost-comparing surgical against medical interventions, topical I/RA may serve as a safe and effective alternative.

Topics: Administration, Topical; Antineoplastic Agents; Carcinoma in Situ; Conjunctival Neoplasms; Corneal Diseases; Follow-Up Studies; Humans; Interferon alpha-2; Neoplasm Recurrence, Local; Retrospective Studies; Treatment Outcome; Tretinoin

Topics: Antiviral Agents; Conjunctival Neoplasms; Humans; Interferons; Melanosis; Tretinoin

Topics: Antineoplastic Agents; Carcinoma in Situ; Conjunctival Neoplasms; Corneal Diseases; Eye Neoplasms; Female; Humans; Interferon-alpha; Male; Tretinoin

Topics: Antineoplastic Agents; Carcinoma in Situ; Conjunctival Neoplasms; Corneal Diseases; Eye Neoplasms; Female; Humans; Interferon-alpha; Male; Tretinoin

To evaluate the long-term recurrence rate of conjunctival and corneal intraepithelial neoplasia (CIN) treated with retinoic acid and topical interferon alfa-2b.. Retrospective, noncomparative, interventional case series.. A total of 89 eyes of 89 patients from 1 institution who were treated between September 2003 and February 2010 for CIN lesions used topical interferon alfa 1 million IU/ml drops 4 times daily and retinoic acid 0.01% once every second day.. Diagnosis was made by biopsy and impression cytology. Patients' notes and clinical photographs were reviewed, and data were analyzed. All eyes were monitored for the possibility of recurrence with a minimum of 1 year of follow-up from the time of documented clinical resolution.. All eyes were monitored for the possibility of recurrence with a minimum of 1 year of follow-up from the time of documented clinical resolution.. Complete clinical resolution of the CIN lesions was achieved in 87 of the 89 eyes treated (97.75%). Two of the 89 eyes treated (2.25%) had only a partial response to treatment; of these 2 patients, 1 was taking cyclosporine for keratitis sicca. For the 87 eyes with complete response, resolution occurred after a mean of 1.69 months (range, 19 days to 6.5 months). Mean follow-up after clinical resolution (tumor-free period) was 51.5 months (range, 11-84 months). Four of the 87 patients with complete response developed a mild allergic papillary conjunctivitis that settled on halving the interferon dose to 0.5 million IU drops and reducing the frequency to 3 times daily. Side effects were limited to 1 case of epithelial microcysts and 1 case of marginal keratitis.. In this group of patients observed with CIN lesions, combination treatment of topical retinoic acid and interferon alfa-2b was effective in treating lesions with minimal self-limited side effects with faster and greater resolution and a longer tumor-free period compared with studies using interferon alfa-2b alone. We hypothesize that topical all-trans retinoic acid and interferon alfa-2b may act synergistically. We believe that combination treatment of interferon alfa-2b and retinoic acid may offer a superior alternative to interferon alfa-2b alone in treating CIN.

Topics: Administration, Topical; Antineoplastic Agents; Carcinoma in Situ; Conjunctival Neoplasms; Corneal Diseases; Drug Therapy, Combination; Eye Neoplasms; Female; Follow-Up Studies; Humans; Interferon alpha-2; Interferon-alpha; Male; Neoplasm Recurrence, Local; Ophthalmic Solutions; Recombinant Proteins; Retrospective Studies; Treatment Outcome; Tretinoin

Topics: Antineoplastic Agents; Cell Line, Tumor; Conjunctival Neoplasms; Humans; Melanoma; Mitomycin; Nitrosourea Compounds; Organophosphorus Compounds; Tretinoin

We report four cases of corneoconjunctival keratinization that were successfully treated with topical retinoic acid ointment. In two cases keratinization was due to squamous metaplasia and in two others it was secondary to intraepithelial corneoconjunctival neoplasia. Treatment reversed severe keratinization in a case of drug-induced pseudopemphigoid and stabilized the disease in one of the two affected eyes without additional treatment. In a case of ocular cicatricial pemphigoid, retinoic acid was useful as an adjuvant therapy to immunosuppression, by reversing keratinization of the conjunctiva. In two cases of corneoconjunctival neoplasia, lesions regressed markedly. Long-term treatment was well tolerated in three patients. Our findings suggest that retinoic acid ointment is effective in treating severe squamous metaplasia in cicatrizing diseases of the conjunctiva. Our findings indicate further that retinoic acid seems to inhibit growth of corneoconjunctival neoplasias and thus might be useful complementary therapy in this situation.

Topics: Administration, Topical; Aged; Aged, 80 and over; Conjunctiva; Conjunctival Diseases; Conjunctival Neoplasms; Conjunctivitis; Cornea; Corneal Diseases; Epithelium; Female; Humans; Keratins; Male; Metaplasia; Tretinoin