Ocular Surface Squamous Neoplasia: A Cohort Study and Updates in the Pathogenesis, Diagnosis, and Medical Management.

Abstract

Purpose: To review the current literature on the pathogenesis, diagnosis, and management of ocular surface squamous neoplasia (OSSN), and to evaluate the efficacy and safety of topical therapies-interferon alpha-2b (IFNα-2b), mitomycin-C (MMC), and 5-fluorouracil (5-FU)-in a retrospective cohort of patients with OSSN.

Method: A comprehensive literature review was conducted alongside a retrospective cohort study involving 43 patients diagnosed with OSSN. Treatment outcomes, recurrence rates, and toxicity profiles associated with IFNα-2b, MMC, and 5-FU were analyzed. Data on treatment duration, number of cycles required for tumor resolution, and associations with patient demographics were assessed.

Results: A mean of 2.56 treatment cycles was required for complete tumor resolution across the cohort. IFNα-2b led to tumor resolution in a shorter time frame compared to 5-FU. No significant correlation was identified between patient demographics and treatment response. However, a history of cancer was associated with larger tumor size and greater limbal involvement at presentation.

Conclusions: Topical agents are effective and well-tolerated treatments for OSSN, with IFNα-2b demonstrating faster response times in this cohort. The literature highlights a lack of prospective randomized trials comparing these therapies. Furthermore, limited understanding of the molecular mechanisms underlying OSSN pathogenesis continues to hinder individualized treatment strategies and risk stratification.