Current concepts and recent updates in the treatment of ocular surface squamous neoplasia

IF 0.9 Q4 OPHTHALMOLOGY Expert Review of Ophthalmology Pub Date : 2023-10-09 DOI:10.1080/17469899.2023.2267763
Bharat Gurnani, Kirandeep Kaur
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Abstract

ABSTRACTIntroduction Ocular surface squamous neoplasia (OSSN) is a broad pathological entity that includes squamous neoplasm of conjunctival and corneal tissue. These various malignancies include conjunctival intraepithelial neoplasia (CIN), corneal epithelial dysplasia, squamous cell carcinoma (SCC), and mucoepidermoid carcinoma. OSSN diagnosis rests on exfoliative cytology, vital dyes, and imaging in the form of confocal microscopy and anterior segment optical coherence tomography. The medical management modalities are topical chemotherapy (Mitomycin C and 5 fluorouracil), immunotherapy (Interferon alpha 2b), and upcoming drugs, such as antivirals, anti-VEGF, and retinoic acid. Excision biopsy with no touch technique remains the gold standard for managing OSSN. However, surgery can lead to recurrence and unfavorable results in some cases.Areas Covered This article provides insights into the treatment aspects of OSSN with an overview of recent updates. The authors have discussed the current concept regarding the medical and surgical management of OSSN. The authors also dwell upon the recent updates along with the expert opinion.Expert Opinion- Although surgery remains the gold standard, topical drugs have revolutionized the management of OSSN. Patients should be closely followed up to look for any side effects. Cost, time duration, cosmesis, and side are the remaining major factors in deciding for medical versus surgical therapy.KEYWORDS: Ocular surface squamous neoplasiamitomycin C5-fluorouracilinterferon alpha 2bexcision biopsy Article highlights Ocular surface squamous neoplasia (OSSN) is a diverse ocular pathology that includes squamous neoplasm of conjunctival and corneal tissueThe important diagnostic modality includes exfoliative and impression cytology, vital dyes, high resolution anterior segment optical coherence tomography, and confocal microscopy.The medical management options of OSSN can be chemotherapeutic agents and immunotherapy.The gold standard for OSSN management is surgical excision biopsy by no touch technique and cryotherapy to the margins.The recent advances in OSSN management comprises human papilloma virus vaccine, light-activated belzupacap sarotalocan, verteporfin, cidofovir, bevacizumab, retinoic acid, and aloe vera.Declaration of interestsThe authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants, or patents received or pending, or royaltiesReviewer disclosuresPeer reviewers on this manuscript have no relevant financial or other relationships to disclose.Additional informationFundingThis paper was not funded.
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眼表鳞状瘤样病变治疗的现状及最新进展
摘要简介眼表鳞状瘤变(OSSN)是一个广泛的病理实体,包括结膜和角膜组织的鳞状肿瘤。这些不同的恶性肿瘤包括结膜上皮内瘤变(CIN)、角膜上皮发育不良、鳞状细胞癌(SCC)和黏液表皮样癌。OSSN的诊断依赖于剥脱性细胞学、重要染料和共聚焦显微镜和前段光学相干断层成像。医疗管理方式是局部化疗(丝裂霉素C和5氟尿嘧啶),免疫治疗(干扰素α 2b),以及即将推出的药物,如抗病毒药物,抗vegf和维甲酸。无接触切除活检技术仍然是治疗OSSN的金标准。然而,在某些情况下,手术可能导致复发和不良结果。本文提供了对OSSN治疗方面的见解,并概述了最近的更新。作者讨论了目前关于OSSN的内科和外科治疗的概念。作者还详细介绍了最近的更新以及专家的意见。专家意见-尽管手术仍然是金标准,局部药物已经彻底改变了OSSN的管理。患者应密切随访,以寻找任何副作用。费用、持续时间、外观和侧边是决定内科还是外科治疗的主要因素。摘要:眼表鳞状瘤变(OSSN)是一种包括结膜和角膜组织鳞状肿瘤在内的多种眼部病理,重要的诊断方法包括剥脱和印迹细胞学检查、活体染料检查、高分辨率前段光学相干断层扫描和共聚焦显微镜检查。OSSN的医疗管理选择可以是化疗药物和免疫治疗。治疗OSSN的金标准是手术切除活检无接触技术和冷冻治疗边缘。OSSN管理的最新进展包括人乳头瘤病毒疫苗、光激活belzupacap sarotalocan、维替波芬、西多福韦、贝伐单抗、维甲酸和芦荟。利益声明作者与任何组织或实体没有任何关联关系或财务参与,这些组织或实体与手稿中讨论的主题或材料有经济利益或经济冲突。这包括就业,咨询,酬金,股票所有权或期权,专家证词,赠款,或已收到或正在申请的专利,或版税。审稿人披露本手稿的每位审稿人没有相关的财务或其他关系要披露。本文未获得资助。
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来源期刊
Expert Review of Ophthalmology
Expert Review of Ophthalmology Health Professions-Optometry
CiteScore
1.40
自引率
0.00%
发文量
39
期刊介绍: The worldwide problem of visual impairment is set to increase, as we are seeing increased longevity in developed countries. This will produce a crisis in vision care unless concerted action is taken. The substantial value that ophthalmic interventions confer to patients with eye diseases has led to intense research efforts in this area in recent years, with corresponding improvements in treatment, ophthalmic instrumentation and surgical techniques. As a result, the future for ophthalmology holds great promise as further exciting and innovative developments unfold.
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