Ocular Surface Squamous Neoplasia: A Survey of Changes in the Standard of Care From 2003 to 2012
Ocular Surface Squamous Neoplasia: A Survey of Changes in the Standard of Care From 2003 to 2012
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DOI：
10.1097/ico.0b013e3182a6ea6c
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发表时间：
2013-12-01
期刊：
影响因子：
2.8
通讯作者：
Stone, Donald U.
中科院分区：
文献类型：
--
作者：
Adler, Eldad;Turner, Joseph R.;Stone, Donald U.
目的：评估眼表鳞状细胞肿瘤(OSSN)眼科医生目前的护理水平，并与2003年收集的数据进行比较。方法：向眼科微生物学和免疫学小组成员发出网络调查邀请函。此外，这项调查还被发布在Keranet的角膜学会列表上。这项调查包括有关OSSN的手术和医疗管理以及护理后随访的问题。在可能的情况下，将本次调查的结果与2003年的调查结果进行比较，以确定护理标准的变化领域。结果：81名眼科医生参与了调查。79%的应答者认为在OSSN中有足够的证据表明局部单一疗法，但只有58%的人报告曾使用局部药物作为单一疗法。一线局部治疗是干扰素2b(56%)，其次是丝裂霉素C(MMC)(37%)。当将2012年的调查与2003年的调查进行比较时，可以看到从单纯手术切除到切除后再进行局部治疗的转变。术后首选的外用制剂是MMC。75%的应答者在前两年每2至4个月对患者进行评估。结论：与2003年相比，2012年局部药物的使用越来越多，无论是与手术切除联合使用，还是作为单一治疗使用。干扰素已经取代MMC成为最常用的局部单一治疗药物，可能是因为良好的安全性和耐受性。为了更好地定义理想的实践模式，需要进行前瞻性随机试验。
Purpose:To evaluate the current standard of care of ophthalmologists who are likely to encounter ocular surface squamous neoplasia (OSSN) in their practices and to compare this with data gathered in 2003.Methods:Invitations to a web-based survey were sent to members of the Ocular Microbiology and Immunology Group. In addition, the survey was posted to the Cornea Society Listserv, Keranet. The survey contained questions regarding the surgical and medical management of OSSN and postcare follow-up. The results of this survey were compared with the results of a 2003 survey, where possible, to identify the areas of change in the standard of care.Results:Eighty-one ophthalmologists participated in the survey. Seventy-nine percent of the responders thought that there was enough evidence for topical monotherapy in OSSN, but only 58% reported ever using topical agents as monotherapy. First-line topical therapy was interferon 2b (56%) followed by mitomycin C (MMC) (37%). A shift from surgical excision alone to excision followed by topical therapy was seen when comparing the 2012 survey to the 2003 survey. The preferred postexcision topical agent was MMC. Seventy-five percent of responders evaluate their patients every 2 to 4 months during the first 2 years.Conclusions:Topical agents were being used more in 2012, either in combination with surgical excision or as monotherapy, compared with those used in 2003. Interferon has replaced MMC as the agent most used for topical monotherapy, possibly because of a favorable safety and tolerance profile. Prospective randomized trials are needed to better define the ideal practice patterns.