Pe'er Jacob, Frucht-Pery Joseph
Department of Ophthalmology, Hadassah-Hebrew University Medical Center, 91120 Jerusalem, Israel.
Am J Ophthalmol. 2005 Feb;139(2):229-34. doi: 10.1016/j.ajo.2004.08.065.
To report our results of 12 consecutive patients with conjunctival primary acquired melanosis (PAM) with atypia who were treated by topical Mitomycin C (MMC).
Retrospective interventional consecutive case series.
Twelve patients with PAM with atypia in one of their eyes who were treated by topical chemotherapy with MMC were included in this case study. Eyes with histologically proven PAM with atypia were treated by two to five courses of 0.04% (0.4 mg/ml) MMC four times a day. Each course lasted 2 continuous weeks. Follow-up was conducted on patients for control of local disease, side effects, and visual acuity in the treated eye.
In all patients, there was complete or partial response to treatment. In four patients, the pigmentation disappeared, whereas in eight patients, some remnants of the pigmentation remained. In seven of these eight patients, the remnants of the pigmentation were stable during the follow-up period of 4 months to 9 years, whereas one in whom re-growth of the PAM was noticed was successfully treated again by topical MMC. No patients lost visual acuity at the end of the follow-up. All side effects of the local chemotherapy were resolved after cessation of the treatment.
Topical MMC chemotherapy is a good alternative to surgical excision and cryotherapy in treating conjunctival PAM with atypia.
报告12例连续接受局部丝裂霉素C（MMC）治疗的伴有异型性的结膜原发性获得性黑素沉着症（PAM）患者的治疗结果。
回顾性干预连续性病例系列。
本病例研究纳入12例单眼患有伴有异型性的PAM且接受MMC局部化疗的患者。经组织学证实为伴有异型性的PAM的眼睛，每天4次接受两至五个疗程的0.04%（0.4mg/ml）MMC治疗。每个疗程持续2周。对患者进行随访，以控制局部病变、副作用以及患眼的视力。
所有患者对治疗均有完全或部分反应。4例患者色素沉着消失，而8例患者仍有一些色素沉着残留。在这8例患者中的7例，色素沉着残留在4个月至9年的随访期内保持稳定，而1例出现PAM复发的患者再次通过局部MMC成功治疗。随访结束时无患者视力丧失。局部化疗的所有副作用在治疗停止后均得到缓解。
局部MMC化疗是治疗伴有异型性的结膜PAM的手术切除和冷冻疗法的良好替代方法。
