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. 2023 Apr:28:108-114.
doi: 10.1016/j.jtos.2022.12.009. Epub 2022 Dec 30.

Long term study of topical interferon α-2b eye drops as primary treatment of ocular surface squamous neoplasia

Wathanee Sripawadkul  1 , Daniela Reyes-Capo  2 , Mike Zein  2 , Adam Wylegala  2 , Ghada Albayyat  2 , Anat Galor  3 , Carol L Karp  4
Affiliations

Long term study of topical interferon α-2b eye drops as primary treatment of ocular surface squamous neoplasia

Wathanee Sripawadkul et al. Ocul Surf. 2023 Apr.

Abstract

Purpose: To assess the efficacy of topical interferon α-2β(IFN) eye drops as a primary treatment for ocular surface squamous neoplasia(OSSN) and evaluate factors that impact response to treatment and recurrence of OSSN.

Method: A retrospective study of 143 OSSN patients treated with topical IFN(1MIU/ml) from January 1998 to June 2021. The diagnosis was based on clinical examination and anterior segment optical coherence tomography, with histologic confirmation was present in 46.2% of patients. Data on demographic, tumor characteristics, treatment outcome, and side effects were collected. The primary outcomes were tumor resolution frequency and recurrence rate. Secondary outcomes were predictive factors for resolution and recurrence and side effects of treatment.

Result: Participants were mostly older (mean age, 69 years, SD 12.9, range 29-97), white(89%) males (74%). Complete tumor resolution was achieved in 80.4% of individuals with a mean time to resolution of 4.2 months (SD 2, range 0.5-12.3 months). On multivariable analysis, history of skin cancer (HR: 0.66, p = 0.05, 95%CI: 0.44-0.99) and immune system abnormalities (HR: 0.37, p = 0.009, 95%CI: 0.18-0.79) reduced the risk of tumor resolution, while a prior history of OSSN (HR: 3.49, p < 0.001, 95%CI: 1.76-6.93) increased the risk of resolution. With a mean follow-up time of 44.3 months (SD 50.9, 0-290 months), the recurrence rate was 0%, 2.3% and 3.1% at 1, 2, and 5 years respectively. Mild hyperemia(18.9%) and pain(10.6%) were the two most common side effects.

Conclusion: Topical IFN eye drops are a safe and effective primary treatment modality for OSSN with a reasonable side effect profile.

Keywords: Conjunctival tumor; Interferon alpha-2b; Interferon α-2b; Ocular surface squamous neoplasia; Outcome; Recurrence; Topical therapy; Treatment.

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Conflict of interest statement

Declaration of competing interest Drs. Karp and Galor: pending PCT/US2022/029,842 with the University of Miami. Dr. Karp began on the medical advisor board for Interfeen Biologics after the submission of this manuscript. The other authors have no financial disclosures to report.

Figures

Figure 1.
Figure 1.
Kaplan-Meier survival curve showing time to tumor resolution.
Figure 2.
Figure 2.
Kaplan-Meier survival curved showing time to tumor recurrence
Figure 3.
Figure 3.
An eighty-one-year-old white female with an ocular surface squamous neoplasia (OSSN) on the right eye. A. Slit lamp image shows a gelatinous and papillary appearance lesion on the temporal bulbar conjunctiva. The black dotted line demonstrates the orientation of the anterior segment optical coherence tomography (AS-OCT) raster. B. AS-OCT showing thickened hyperreflective epithelium (asterisk) with an abrupt transition (white arrow). C. Slit lamp image of the same eye after 6 months of topical interferon α-2β(IFN). Mild hyperemia was noted. The black dotted line demonstrates the orientation of the AS-OCT raster. D. AS-OCT showing resolved tumor with normal thickness epithelium (white arrow) following treatment.
See this image and copyright information in PMC

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