Objective To evaluate topical interferon alfa 2b (IFNα2b) as a single therape utic agent in the treatment of presumed recurrent corneal and conjunctival intra epithelial neoplasia. Design Noncomparative, retrospectiv...Objective To evaluate topical interferon alfa 2b (IFNα2b) as a single therape utic agent in the treatment of presumed recurrent corneal and conjunctival intra epithelial neoplasia. Design Noncomparative, retrospective case series. Particip ants Seven consecutive patients with recurrent corneal and conjunctival intraepi thelial neoplasia diagnosed at the University of Minnesota from July 2000 to Nov ember 2003 were studied retrospectively. All patients had a history of histologi cally proven primary corneal and conjunctival intraepithelial neoplasia and were treated by surgery, cryotherapy, radiation, and/or topical mitomycin C before r ecurrence. Intervention Patients with a clinical diagnosis of recurrent corneal and conjunctival intraepithelial neoplasia were treated with recombinant topical IFNα2b drops (1 million IU/ml) 4 times daily until lesion resolution was noted. Main outcome measures A review of medical records was performed to asse ss the duration of and response to treatment with topical IFNα2b, defined by cl inical resolution of corneal and conjunctival intraepithelial neoplasia. Results The average age of the 7 patients at the initiation of topical IFNα2b treatmen t for presumed recurrent corneal and conjunctival intraepithelial neoplasia was 68.7 years (range, 54-88). Six of 7 patients had successful treatment of recurr ent corneal and conjunctival intraepithelial neoplasia lesions with topical IFN α2b treatment. The average length of IFNα2b treatment to resolution of recurre nt corneal and conjunctival intraepithelial neoplasia was 14.5 weeks (range, 5- 24). After treatment with topical IFNα2b for recurrent corneal and conjunctival intraepithelial neoplasia, 2 patients had another recurrence of corneal and con junctival intraepithelial neoplasia, noted at 1 year and 2 months, respectively. The average post treatment follow-up was 11.7 months (range, 8-17) after the resolution of recurrent corneal and conjunctival intraepithelial neoplasia. No s ide effects of treatment were noted in any patient. Conclusions Topical IFNα2b as a single therapeutic agent is an effective treatment of presumed recurrent co rneal and conjunctival intraepithelial neoplasia. It offers the benefits of topi cal therapy and avoids the risks of surgical or other interventions specifically , ocular surface toxicity, cicatricial conjunctival changes, and limbal stem cel l deficiency. Larger controlled studies with longer follow-up periods are recom mended to confirm the longterm efficacy and safety of this topical treatment.展开更多
Objective: To report in vivo corneal confocal microscopic findings of patients with central cloudy dystrophy of Franc.ois. Methods: Two unrelated patients, a 78- year- old man and a 75- year- old woman, with central c...Objective: To report in vivo corneal confocal microscopic findings of patients with central cloudy dystrophy of Franc.ois. Methods: Two unrelated patients, a 78- year- old man and a 75- year- old woman, with central cloudy dystrophy of Franc.ois were examined using routine slitlamp biomicroscopy and confocal microscopy. Results: In both cases, slitlamp biomicroscopy showed bilateral polygonal opacities separated by clear spaces. The corneal opacities were most prominent centrally and were located in the deeper stromal layer immediately anterior to the Descemet membrane. By confocal microscopy, normal superficial and basal epithelial layers, midstromal layers, and endothelial layers were noted in both cases. However, small highly refractile granules and deposits were observed in the anterior stromal layer in both cases. Also, multiple dark striae among the extracellular matrix with increased intensities were observed in the posterior stroma adjacent to the corneal endothelial layer in both cases. Conclusions: Abnormal stromal deposits and multiple dark striae were observed in central cloudy dystrophy of Franc.ois using in vivo corneal confocal microscopy. Use, of confocal microscopy to investigate these abnormal stromal opacities may be helpful in differentiating various corneal stromal pathologic features.展开更多
文摘Objective To evaluate topical interferon alfa 2b (IFNα2b) as a single therape utic agent in the treatment of presumed recurrent corneal and conjunctival intra epithelial neoplasia. Design Noncomparative, retrospective case series. Particip ants Seven consecutive patients with recurrent corneal and conjunctival intraepi thelial neoplasia diagnosed at the University of Minnesota from July 2000 to Nov ember 2003 were studied retrospectively. All patients had a history of histologi cally proven primary corneal and conjunctival intraepithelial neoplasia and were treated by surgery, cryotherapy, radiation, and/or topical mitomycin C before r ecurrence. Intervention Patients with a clinical diagnosis of recurrent corneal and conjunctival intraepithelial neoplasia were treated with recombinant topical IFNα2b drops (1 million IU/ml) 4 times daily until lesion resolution was noted. Main outcome measures A review of medical records was performed to asse ss the duration of and response to treatment with topical IFNα2b, defined by cl inical resolution of corneal and conjunctival intraepithelial neoplasia. Results The average age of the 7 patients at the initiation of topical IFNα2b treatmen t for presumed recurrent corneal and conjunctival intraepithelial neoplasia was 68.7 years (range, 54-88). Six of 7 patients had successful treatment of recurr ent corneal and conjunctival intraepithelial neoplasia lesions with topical IFN α2b treatment. The average length of IFNα2b treatment to resolution of recurre nt corneal and conjunctival intraepithelial neoplasia was 14.5 weeks (range, 5- 24). After treatment with topical IFNα2b for recurrent corneal and conjunctival intraepithelial neoplasia, 2 patients had another recurrence of corneal and con junctival intraepithelial neoplasia, noted at 1 year and 2 months, respectively. The average post treatment follow-up was 11.7 months (range, 8-17) after the resolution of recurrent corneal and conjunctival intraepithelial neoplasia. No s ide effects of treatment were noted in any patient. Conclusions Topical IFNα2b as a single therapeutic agent is an effective treatment of presumed recurrent co rneal and conjunctival intraepithelial neoplasia. It offers the benefits of topi cal therapy and avoids the risks of surgical or other interventions specifically , ocular surface toxicity, cicatricial conjunctival changes, and limbal stem cel l deficiency. Larger controlled studies with longer follow-up periods are recom mended to confirm the longterm efficacy and safety of this topical treatment.
文摘Objective: To report in vivo corneal confocal microscopic findings of patients with central cloudy dystrophy of Franc.ois. Methods: Two unrelated patients, a 78- year- old man and a 75- year- old woman, with central cloudy dystrophy of Franc.ois were examined using routine slitlamp biomicroscopy and confocal microscopy. Results: In both cases, slitlamp biomicroscopy showed bilateral polygonal opacities separated by clear spaces. The corneal opacities were most prominent centrally and were located in the deeper stromal layer immediately anterior to the Descemet membrane. By confocal microscopy, normal superficial and basal epithelial layers, midstromal layers, and endothelial layers were noted in both cases. However, small highly refractile granules and deposits were observed in the anterior stromal layer in both cases. Also, multiple dark striae among the extracellular matrix with increased intensities were observed in the posterior stroma adjacent to the corneal endothelial layer in both cases. Conclusions: Abnormal stromal deposits and multiple dark striae were observed in central cloudy dystrophy of Franc.ois using in vivo corneal confocal microscopy. Use, of confocal microscopy to investigate these abnormal stromal opacities may be helpful in differentiating various corneal stromal pathologic features.
