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      Recurrent Corneal Erosion Induced by 1% 5-Fluorouracil Solution

      case-report
      Author(s): 1 , , 2
      Editor(s): ,
      Publication date (Electronic, pub):
      Publication date (Electronic, collection):
      Journal: Cureus
      Publisher: Cureus
      Keywords: 5-fluorouracil, chemo-holidays, conjunctival papilloma, corneal epithelial erosion, cytotoxic anticancer drugs

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          Abstract

          Cytotoxic anticancer drug solution eye drops can hinder the cell division of corneal basal cell division and corneal limbal epithelial stem cell migration. We discuss a case involving recurrent corneal epithelial erosions induced by 1% 5-fluorouracil (5-FU) solution eye drops. A 68-year-old male with conjunctival papilloma on his left eye underwent recurrences three times and additional tumor excision. He was prescribed 1% 5-FU solution eye drops two times a day without drug holidays and experienced recurrent corneal epithelial erosion. This report highlights the necessity of drug holidays for patients receiving cytotoxic anticancer drug solution eye drops.

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          The X, Y, Z hypothesis of corneal epithelial maintenance.

          R A Thoft, J Friend (1983)
          Article 0 comments Cited 72 times – based on 0 reviews     Review now
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            Update on pharmacotherapy for ocular surface squamous neoplasia

            Ghada Al Bayyat, Dan Arreaza-Kaufman, Nandini Venkateswaran … (2019)
            The most frequently encountered non-pigmented tumor of the ocular surface is ocular surface squamous neoplasia (OSSN). Over the past two decades, the pharmacological management of OSSN has grown, with topical 5-fluorouracil, mitomycin, and interferon alpha 2b all being successfully used to treat this disease. Other agents, such as anti-vascular endothelial growth factor (VEGF), retinoic acid, cidofovir and Aloe vera, have less frequently been used in the treatment of OSSN. This review will discuss these pharmacologic agents, summarizing available data and presenting the approach to the treatment of these tumors.
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              Comparison of Topical 5-Fluorouracil and Interferon Alfa-2b as Primary Treatment Modalities for Ocular Surface Squamous Neoplasia

              Nandini Venkateswaran, Carolina Mercado, Anat Galor … (2019)
              To compare the efficacy of topical 5-fluorouracil 1% ( 5FU) and interferon alfa-2b 1 MIU/mL (IFN) eye drops as primary treatment modalities for ocular surface squamous neoplasia (OSSN). Retrospective, comparative, interventional case series. Fifty-four patients who received 5FU and 48 patients who received IFN as primary therapy for OSSN were included. Primary outcome measures were the frequency of clinical resolution and time to OSSN recurrence by treatment modality. Secondary outcome was the frequency of side effects with each therapy. The mean age of patients was 68 years. More Hispanics were treated with 5FU. In a univariable analysis, frequency of OSSN resolution was higher with 5FU (96.3%, n = 52) than with IFN (81.3%, n = 39), p=0.01. In a multivariable analysis, treatment modality did not remain a significant predictor of resolution. In patients whose OSSN resolved, time to resolution was similar with both agents, (5FU - mean 6.6 months, standard deviation (SD) 4.5 versus IFN - mean 5.5 months, SD 2.9, p = 0.17). Of the 52 eyes whose OSSN resolved with 5FU, 11.5 % of lesions (n=6) recurred while of the 39 eyes whose OSSN resolved with IFN, 5.1% of lesions (n = 2) recurred, p=0.46. Kaplan Meier survival curves of OSSN recurrence were similar between groups (log rank=0.16). One-year recurrence rates were 11.4% with 5FU and 4.5% with IFN. Eyelid edema (p=0.04) and tearing (p=0.02) were more significant with 5FU. This is the first direct comparison study between 5FU and IFN eye drops as primary treatment modalities for OSSN. Both modalities resulted in a high frequency of tumor resolution and low recurrence rates and are effective treatment options for OSSN.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Cureus
                Journal ID (iso-abbrev): Cureus
                Journal ID (issn): 2168-8184
                Title: Cureus
                Publisher: Cureus (Palo Alto (CA) )
                ISSN (Electronic): 2168-8184
                Publication date (Electronic, pub): 7 November 2024
                Publication date (Electronic, collection): November 2024
                Volume: 16
                Issue: 11
                Electronic Location Identifier: e73238
                Affiliations
                [1 ] Ophthalmology, Tsukazaki Hospital, Himeji, JPN
                [2 ] Ophthalmology, Hiroshima University, Hiroshima, JPN
                Author notes
                Article
                DOI: 10.7759/cureus.73238
                PMC ID: 11624916
                PubMed ID: 39650961
                SO-VID: f4670d35-abdf-432f-9439-0452125b0937
                Copyright © Copyright © 2024, Tanaka et al.
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date accepted : 4 November 2024
                Categories
                Subject: Pharmacology
                Subject: Ophthalmology

                Keywords: 5-fluorouracil,chemo-holidays,conjunctival papilloma,corneal epithelial erosion,cytotoxic anticancer drugs
                Data availability:
                Keywords: 5-fluorouracil, chemo-holidays, conjunctival papilloma, corneal epithelial erosion, cytotoxic anticancer drugs

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