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Mitomycin C for Local Treatment of Corneal Intraepithelial Neoplasia (CIN)

Ottenberg D., Richter M., Bechrakis N. E., Foerster M. H.,
Freie Universität Berlin, Klinikum Benjamin Franklin, Augenklinik (Berlin)

Background: Corneal intraepithelial neoplasia (CIN) is a rare, slowly progressing dysplasia of the corneal epithelium with low potential of malignancy. Until now treatment options included excision, radiation and cryotherapy.
Methods: We present an 81-year old patient with CIN treated by local application of mitomycin C 0,02% and with a one year follow-up and photo documentation.
Results: The patient had noticed visual deterioration in the left eye. Visual acuity was 0,2 on first examination. The histological examination of a corneal scrape performed in a different hospital, was consistent with the diagnosis of carcinoma in situ. Two cycles of mitomycin C eye drops four times daily for a time period of 14 days were given. During the treatment the CIN decreased rapidly until complete disappearance. Visual acuity increased to 0,4. During the treatment a reversible punctate keratitis developed. The 12 month follow up did not show any sign of CIN recurrence.
Discussion: In our case local application with mitomycin C was an effective and not aggressive treatment of CIN compared to other therapies such as excision, radiation and cryotherapy. The efficacy of local cytostatic substances (mitomycin C, 5-fluorouracil) is already described in small patient series in the literature.