Bolek Bartłomiej, Wylęgała Adam, Teper Sławomir, Kokot Joanna, Wylęgała Edward
Chair and Clinical Department of Ophthalmology, School of Medicine in Zabrze, Medical University of Silesia in Katowice, District Railway Hospital, Katowice, Poland.
Medicine (Baltimore). 2020 Feb;99(7):e19181. doi: 10.1097/MD.0000000000019181.
Conjunctival papilloma is a benign neoplastic lesion of epithelial origin, with a minimal tendency toward malignancy and an exophytic growth type. Etiological factors that contribute to the appearance of papilloma are UV exposure, HPV infection, smoking, and immunodeficiency. A case report of limbal conjunctival papilloma treatment with topical interferon alpha-2b eye drops applied to the conjunctival sac.
A 49-year-old female patient treated in the Clinical Department of Ophthalmology for conjunctival lesion located in the temporal quadrant near the limbus of the right eye. Ocular examination of the patient's eye did not show any abnormalities: visual acuity-20/20, intraocular pressure-16 mmHg.
During physical examination, a broad-based pink lesion of size 4 mm × 6 mm was found in interpalpebral bulbar conjunctiva with prominent feeder vessels and soft consistency. Lesion in the biomicroscopic examination did not show any sign of malignancy. In Swept Source Optical Coherence Tomography (SS-OCT) there was no sign of infiltration into sclera or cornea. In vivo confocal microscopy (IVCM) examination, revealed loss of the normal conjunctival epithelium - hyper-reflective cells, variation of cell size. A clinical diagnosis of limbal conjunctival papilloma was made.
Interferon alpha-2b 1 million IU/ml eye drops were applied 4 times a day for 5 months. The treatment lasted 5 months without changing the dosing regimen. Three months after the start of the interferon treatment, a complete regression of the lesion was achieved. Treatment was continued for the following 2 months. Controlled IVCM after 6 months showed only few hyper-reflective cells and fibrotic tissue.
Treatment of conjunctival papilloma with topical interferon alpha-2b led to the complete regression of the lesion. Although after the therapy the conjunctiva appears normal both in slit lamp and in the OCT examination, there is a noticeable fibrosis of the tissue in confocal microscopy. During the 14-month follow-up period, there were no recurrent lesions.
In this study, topical interferon alpha-2b has been shown to be an effective and safe therapy for small-to-medium-size conjunctival papilloma without any sign of malignancy.
结膜乳头瘤是一种起源于上皮的良性肿瘤性病变，恶变倾向极小，呈外生性生长类型。导致乳头瘤出现的病因包括紫外线暴露、人乳头瘤病毒（HPV）感染、吸烟和免疫缺陷。本文报告一例应用局部干扰素α-2b滴眼液滴眼治疗角膜缘结膜乳头瘤的病例。
一名49岁女性患者因右眼角膜缘颞侧象限的结膜病变在眼科临床科室接受治疗。对患者眼部进行检查未发现任何异常：视力20/20，眼压16 mmHg。
体格检查时，在睑裂区球结膜发现一个基底较宽的粉红色病变，大小为4 mm×6 mm，有明显的供血血管，质地柔软。生物显微镜检查病变未显示任何恶性迹象。扫频源光学相干断层扫描（SS-OCT）检查未发现巩膜或角膜浸润迹象。活体共聚焦显微镜（IVCM）检查显示正常结膜上皮缺失——高反射细胞，细胞大小不一。临床诊断为角膜缘结膜乳头瘤。
应用100万IU/ml的干扰素α-2b滴眼液，每天滴眼4次，持续5个月。治疗持续5个月，给药方案未改变。干扰素治疗开始3个月后，病变完全消退。随后继续治疗2个月。6个月后进行的对照IVCM检查仅显示少数高反射细胞和纤维化组织。
局部应用干扰素α-2b治疗结膜乳头瘤使病变完全消退。尽管治疗后裂隙灯和OCT检查显示结膜外观正常，但共聚焦显微镜检查发现组织有明显纤维化。在14个月的随访期内，未出现复发病变。
在本研究中，局部应用干扰素α-2b已被证明是治疗无任何恶性迹象的中小尺寸结膜乳头瘤的一种有效且安全的疗法。
