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Updated: Aug 11, 2025
Author Spotlight: Anterior HR-OCT as a Non-Invasive Tool for Characterizing Ocular Surface Squamous Neoplasia
Published on: August 9, 2024
Medical treatment for ocular surface squamous neoplasia
David Monroy1, Andres Serrano2, Anat Galor1,3
1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
Abstract:
Ocular surface squamous neoplasia (OSSN) is the most common non-melanocytic tumour of the ocular surface. Surgical excision with wide margins using the "no-touch" method was originally the most popular treatment for OSSN. However, in the past two decades, the use of topical medications for OSSN treatment has gained a reputation amongst ophthalmologists for being an effective alternative to surgical excision. Furthermore, technological advancements, such as those seen in high-resolution optical coherence tomography (HR-OCT) for the anterior segment, have facilitated the diagnosis and monitoring of OSSN. When selecting a topical agent, interferon alpha-2b (IFNα-2b) and 5-fluorouracil (5-FU) are two of the gentlest medications used for OSSN and are often considered first line therapies due to their high-resolution rates and mild side effect profiles. Mitomycin C (MMC), on the other hand, has a highly toxic profile; therefore, while effective, in our hands it is considered as a second-line treatment for OSSN if the other modalities fail. In addition, newer and less studied agents, such as immune checkpoint inhibitors, retinoic acid, aloe vera, and anti-vascular endothelial growth factor have anti-neoplastic properties and have shown potential for the treatment of OSSN. We enclose an updated literature review of medical treatments for OSSN.
Insights
Topical medications like interferon alpha-2b and 5-fluorouracil are effective first-line treatments for ocular surface squamous neoplasia (OSSN). Mitomycin C is a second-line option, while newer agents show promise for OSSN management.
Area of Science:
- Ophthalmology
- Oncology
- Dermatology
Background:
- Ocular surface squamous neoplasia (OSSN) is the most common non-melanoma tumor affecting the eye's surface.
- Historically, surgical excision was the primary treatment, but topical therapies have emerged as effective alternatives.
- Advancements in diagnostic tools like high-resolution optical coherence tomography (HR-OCT) aid in OSSN detection and monitoring.
Purpose of the Study:
- To provide an updated literature review on medical treatments for OSSN.
- To compare the efficacy and safety profiles of various topical agents for OSSN.
- To discuss emerging therapies for OSSN.
Main Methods:
- Literature review of medical treatments for OSSN.
- Analysis of topical agents including interferon alpha-2b (IFNα-2b), 5-fluorouracil (5-FU), and mitomycin C (MMC).
- Exploration of newer agents like immune checkpoint inhibitors, retinoic acid, and anti-VEGF therapies.
Main Results:
- Interferon alpha-2b (IFNα-2b) and 5-fluorouracil (5-FU) are effective and well-tolerated first-line topical treatments for OSSN.
- Mitomycin C (MMC) is effective but considered a second-line option due to its toxicity.
- Emerging agents demonstrate potential anti-neoplastic properties for OSSN treatment.
Conclusions:
- Topical medications offer a viable and often preferred alternative to surgery for OSSN.
- The choice of topical agent depends on efficacy, side effect profile, and treatment line.
- Further research into newer agents may expand therapeutic options for OSSN.
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