Royal Prince Alfred Hospital, University of Sydney, Sydney, Australia.
Ophthalmology. 2012 Oct;119(10):1969-73. doi: 10.1016/j.ophtha.2012.03.045. Epub 2012 Jun 14.
To evaluate the long-term recurrence rate of conjunctival and corneal intraepithelial neoplasia (CIN) treated with retinoic acid and topical interferon alfa-2b.
Retrospective, noncomparative, interventional case series.
A total of 89 eyes of 89 patients from 1 institution who were treated between September 2003 and February 2010 for CIN lesions used topical interferon alfa 1 million IU/ml drops 4 times daily and retinoic acid 0.01% once every second day.
Diagnosis was made by biopsy and impression cytology. Patients' notes and clinical photographs were reviewed, and data were analyzed. All eyes were monitored for the possibility of recurrence with a minimum of 1 year of follow-up from the time of documented clinical resolution.
All eyes were monitored for the possibility of recurrence with a minimum of 1 year of follow-up from the time of documented clinical resolution.
Complete clinical resolution of the CIN lesions was achieved in 87 of the 89 eyes treated (97.75%). Two of the 89 eyes treated (2.25%) had only a partial response to treatment; of these 2 patients, 1 was taking cyclosporine for keratitis sicca. For the 87 eyes with complete response, resolution occurred after a mean of 1.69 months (range, 19 days to 6.5 months). Mean follow-up after clinical resolution (tumor-free period) was 51.5 months (range, 11-84 months). Four of the 87 patients with complete response developed a mild allergic papillary conjunctivitis that settled on halving the interferon dose to 0.5 million IU drops and reducing the frequency to 3 times daily. Side effects were limited to 1 case of epithelial microcysts and 1 case of marginal keratitis.
In this group of patients observed with CIN lesions, combination treatment of topical retinoic acid and interferon alfa-2b was effective in treating lesions with minimal self-limited side effects with faster and greater resolution and a longer tumor-free period compared with studies using interferon alfa-2b alone. We hypothesize that topical all-trans retinoic acid and interferon alfa-2b may act synergistically. We believe that combination treatment of interferon alfa-2b and retinoic acid may offer a superior alternative to interferon alfa-2b alone in treating CIN.
评估用维甲酸和局部干扰素 alfa-2b 治疗结膜和角膜上皮内瘤变（CIN）的长期复发率。
回顾性、非对照、干预性病例系列研究。
2003 年 9 月至 2010 年 2 月期间，一家机构共对 89 例 89 只眼因 CIN 病变接受治疗，使用局部干扰素 alfa 100 万 IU/ml 滴眼剂，每日 4 次，维甲酸 0.01%隔日一次。
通过活检和印迹细胞学诊断。回顾患者的病历和临床照片，并进行数据分析。所有患者均接受了至少 1 年的随访，以监测可能出现的复发，随访时间从记录的临床缓解开始。
所有患者均接受了至少 1 年的随访，以监测可能出现的复发，随访时间从记录的临床缓解开始。
89 只眼中有 87 只（97.75%）完全缓解 CIN 病变。2 只眼（2.25%）治疗仅部分缓解；这 2 例患者中，1 例因干燥性角膜炎而服用环孢素。对于 87 只完全缓解的眼，平均缓解时间为 1.69 个月（范围，19 天至 6.5 个月）。临床缓解后（无肿瘤期）的平均随访时间为 51.5 个月（范围，11-84 个月）。4 例完全缓解的患者出现轻度过敏性乳头性结膜炎，将干扰素剂量减半至 50 万 IU 滴眼剂，每日 3 次，即可缓解。副作用仅限于 1 例上皮微囊和 1 例边缘性角膜炎。
在本研究中，观察到用局部维甲酸和干扰素 alfa-2b 联合治疗 CIN 病变，与单独使用干扰素 alfa-2b 相比，治疗病变更快、更彻底，缓解时间更长，副作用最小。我们假设局部全反式维甲酸和干扰素 alfa-2b 可能具有协同作用。我们认为，干扰素 alfa-2b 和维甲酸联合治疗可能是治疗 CIN 的一种优于单独使用干扰素 alfa-2b 的替代方法。
