Topical pharmacotherapy for the management of ocular surface squamous neoplasia

Abstract

Abstract Ocular surface squamous neoplasia (OSSN) encompasses a spectrum of dysplastic and neoplastic conditions affecting the conjunctiva and cornea, ranging from intraepithelial neoplasia to invasive squamous cell carcinoma. Traditional management of OSSN has primarily involved surgical excision, often supplemented by cryotherapy. However, the emergence of topical pharmacotherapies has significantly transformed the treatment landscape, offering noninvasive alternatives that may reduce recurrence rates and preserve ocular surface integrity. This review provides a comprehensive analysis of the current topical pharmacotherapeutic agents used in OSSN, including interferon alpha-2b, 5-fluorouracil, and mitomycin C. We evaluate the mechanisms of action, clinical efficacy, dosing regimens, and adverse effect profiles of these agents. In addition, the review discusses the selection criteria for topical versus surgical management, the role of adjuvant therapy, and the latest advancements in drug delivery systems. By synthesizing recent clinical trials and case studies, this article aims to guide clinicians in optimizing treatment strategies for OSSN, highlighting the potential of topical pharmacotherapy to improve patient outcomes while minimizing treatment-related morbidity.