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Challenging Treatment of Ocular Surface Squamous Neoplasia in Patients with Atopic Disease
Authors:Lily Zhang  Carolina Mercado  Anat Galor  Edward J Holland  Gaofeng Wang
Institution:1. Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami, Miami, Florida, USA;2. Miami Veterans Administration Medical Center, Miami, Florida, USA;3. Cincinnati Eye Institute, Cincinnati, Ohio, USA;4. John P. Hussman Institute for Human Genomics, Miami, Florida, USA
Abstract:Purpose: Few studies have described ocular surface squamous neoplasia (OSSN) and its association with atopic diseases and there is no consensus on the course of OSSN in atopic patients. We thereby report three patients with atopy and OSSN.

Methods: Retrospective case series.

Results: Three male patients with mean age of 73 presented with OSSN and history of atopy treated with immunosuppressant therapy. Their histories included atopic dermatitis and keratoconjunctivitis. All patients had treatment complicated by multiple surgeries, recurrences, or advanced disease. The patients initially received medical treatment with topical interferon-alpha-2b (IFNα2b). However, all the patients had recurrences and required modification of treatment including topical 5-fluorouracil (5-FU).

Conclusion: We report on three patients with a history of atopy whose OSSN presentation and course was challenging. Overall, our cases responded better to topical 5-fluorouracil compared to topical interferon-alpha-2b, but recurrences were common. These patients may benefit from more aggressive and long-term treatment.

Keywords:Atopy  ocular surface squamous neoplasia  OSSN  atopic disease  5- fluorouracil  interferon-alpha-2b
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