Diagnosis and medical management of ocular surface squamous neoplasia

Introduction: Topical chemotherapy has gained popularity among clinicians for the treatment of ocular surface squamous neoplasia (OSSN). The principal topical chemotherapy agents used in the management of OSSN are interferon-α2b, 5-fluorouracil, and mitomycin C. High-resolution optical coherence tomography (HR-OCT) is a non-invasive technique that can differentiate OSSN from other ocular surface lesions. Areas covered: This review highlights the current regimens and diagnostic modalities used in managing OSSN. A review of the literature was performed using the keywords ‘conjunctival intraepithelial neoplasia’, ‘ocular surface squamous neoplasia’, ‘optical coherence tomography’, ‘interferon-α2b’, ‘5-fluorouracil’ and ‘mitomycin C’. Expert commentary: Topical chemotherapy for OSSN can be used as primary therapy, for chemoreduction prior to surgical excision, and postoperatively to prevent tumor recurrence. It has the advantage of treating microscopic disease as well as large tumors. HR-OCT provides an ‘optical biopsy’ that can assist in diagnosis and guide management of OSSN lesions.