Related Experiment Video
Updated: Aug 16, 2026
Impression Cytology of the Lid Wiper Area
Published on: August 9, 2016
Impression cytology following mitomycin C therapy for ocular surface squamous neoplasia
1Department of Anatomical Pathology, St Vincent's Hospital, Melbourne, Victoria, Australia. mcelevpa@svhm.org.au
Background/Aims:
Topical mitomycin C (MMC) therapy has been used for treatment of ocular surface squamous neoplasia (OSSN) since 1994. Relatively few studies have reported the cellular changes in ocular surface following MMC.
Methods:
Impression cytology was studied in four patients with ocular surface squamous neoplasia, either primary or recurrence after previous excisional biopsy. The authors studied samples obtained using Millipore filters at intervals between 4 and 17 weeks after commencement of MMC, and compared them with pretreatment cytology.
Results:
MMC induced changes of cytomegaly, cytoplasmic vacuolation, nucleomegaly with nuclear wrinkling, and binucleation or multinucleation were seen in some cells in all samples. However, nuclear/cytoplasmic (N/C) ratio in these enlarged cells was normal. These changes mimicked those seen following radiation therapy in uterine cervix. Changes of increased nuclear and cell size with increased N/C ratio were seen in some dysplastic cells. The predominant form of cell death was apoptosis with fewer cells showing necrosis.
Conclusions:
MMC appears to produce cell death in OSSN by apoptosis and necrosis. Cellular changes related to MMC mimic those caused by radiation-cytomegaly, nucleomegaly, and vacuolation. MMC related changes may persist in ocular surface epithelium for at least 8 months following MMC therapy.
Insights
Topical mitomycin C (MMC) therapy causes cellular changes in ocular surface squamous neoplasia (OSSN) by inducing apoptosis and necrosis. These MMC-induced cellular alterations resemble radiation effects and may persist long-term.
Area of Science:
- Ophthalmology
- Oncology
- Cell Biology
Background:
- Topical mitomycin C (MMC) has been a treatment for ocular surface squamous neoplasia (OSSN) since 1994.
- Limited research exists on the specific cellular effects of MMC on the ocular surface.
Purpose of the Study:
- To investigate the cellular changes in ocular surface squamous neoplasia (OSSN) following topical mitomycin C (MMC) therapy.
- To compare MMC-induced cellular alterations with those of radiation therapy.
Main Methods:
- Impression cytology was performed on four patients with OSSN (primary or recurrent).
- Samples were collected 4-17 weeks after initiating MMC therapy and compared to pre-treatment cytology.
- Cellular morphology, including size, nuclear/cytoplasmic ratio, and cell death mechanisms, were analyzed.
Main Results:
- MMC induced cytomegaly, vacuolation, nucleomegaly, nuclear wrinkling, and multinucleation in some cells.
- Enlarged cells maintained a normal nuclear/cytoplasmic ratio; dysplastic cells showed increased size and N/C ratio.
- Apoptosis was the predominant cell death mechanism, with some necrosis observed.
Conclusions:
- Topical mitomycin C induces cell death in OSSN via apoptosis and necrosis.
- MMC-induced cellular changes (cytomegaly, nucleomegaly, vacuolation) mimic radiation therapy effects.
- These MMC-related cellular changes can persist in the ocular surface epithelium for at least 8 months.
