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Medical therapies may be preferred for treatment of ocular surface tumors
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 Carol L. Karp |
MIAMI — Medical therapy may be a favored alternative to surgery for squamous neoplasia tumors, and new imaging technologies could aid treatment, a presenter here said.
"Excision with cryotherapy is successful but can leave residual disease. Mitomycin, fluorouracil [and] interferon are useful alternatives in the treatment of disease, and imaging techniques can help us treat this subtle lesion," Carol L. Karp, MD, said at the Bascom Palmer Eye Institute 50th Anniversary Scientific Meeting.
Of available therapies, which include topical mitomycin and 5-fluorouracil 1%, Dr. Karp prefers interferon alpha-2b. Treatment may be delivered via topical drops or subconjunctival injection, and if a patient has no compliance or insurance barriers, Dr. Karp favors drops. This method is gentle, well-tolerated and causes no pain; however, it requires daily application, is associated with slow resolution (usually 3 to 4 months), demands compounding and costs roughly $225 a month, she said.
If compliance or cost issues arise, Dr. Karp performs weekly injections. Interferon delivered subconjunctivally ensures compliance and typically results in rapid resolution after two to five injections. Conversely, flu-like symptoms may occur.
Additionally, Dr. Karp uses ultrahigh-resolution optical coherence tomography to image tumors before, during and after treatment.
"[Ultrahigh-resolution OCT] has really changed the way I practice ocular surface oncology. I can diagnose subtle lesions and also see when the tumor is gone," Dr. Karp said.
- Disclosure: Dr. Karp has no relevant financial disclosures.