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Case Reports
. 2021 Jul 20:11:Doc11.
doi: 10.3205/oc000184. eCollection 2021.

Acute anterior uveitis after topical interferon for conjunctival intraepithelial neoplasia (CIN)

Ameay V Naravane  1 , Jacquelyn Weber  1 , Grishma Barucha  2 , Joshua H Hou  1
Affiliations
Case Reports

Acute anterior uveitis after topical interferon for conjunctival intraepithelial neoplasia (CIN)

Ameay V Naravane et al. GMS Ophthalmol Cases. .

Abstract

Objective: Ocular surface squamous neoplasia (OSSN) is the most common type of non-melanocytic ocular surface tumor. Conjunctival intraepithelial neoplasia (CIN) is a type of OSSN that be medically managed by either topical interferon alpha-2b (IFN α-2b), 5-fluorouracil (5-FU), or mitomycin C. While a paradoxical response to IFN α-2b in the HIV population has been reported, we report a case of a paradoxical response in an immunocompetent individual. Methods: A 65-year-old immunocompetent female presents to the clinic with CIN. Results: She is started on topical IFN α-2b, resulting in an unexpected hypopyon, increased corneal epithelial defect, and increased size of the lesion. Switching to topical 5-FU resulted in decreasing size of the CIN lesion and resolution of the epithelial defect. Conclusions: Topical IFN α-2b can produce a paradoxical worsening of CIN lesions in some patients. Providers should be aware of this reaction, as well as the presenting signs and symptoms, to make appropriate treatment changes when treating CIN.

Keywords: 5-FU; CIN; IFN alpha-2b; OSSN; anterior uveitis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1. A) CIN with 360-degree limbal involvement; B) Perilimbal gelatinous lesion with vascular loops; C) CIN with perilimbal lesion extending to the temporal bulbar conjunctiva
Figure 2
Figure 2. Enlarging epithelial defect and hypopyon
Figure 3
Figure 3. Enlargement of CIN, increased corneal epithelial defect size
Figure 4
Figure 4. Diminished CIN two weeks after starting 5-FU; note regressing superior vessels
Figure 5
Figure 5. Diminished CIN, resolving epithelial defect 1.5 months after 5-FU therapy initiation
Figure 6
Figure 6. Resolution of CIN, small inferior corneal neovascularization, resolved epithelial defect with scarring and some residual amniotic membrane inferotemporally
See this image and copyright information in PMC

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