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2021 OMIG Abstract
Conjunctival Papilloma Treatment Outcomes: A 12-Year-Retropsective Study
Wathanee Sripawadkul1,3, Mike Zein, MS1, Anat Galor1,2, Carol L. Karp1
1Bascom Palmer Eye Institute, University of Miami, Miami, Florida; 2Department of Ophthalmology, Miami Veterans Administration Medical Center, Miami, Florida; 3Srinakharinwirot University, Thailand
Purpose: Conjunctival papilloma is a human papilloma virus-mediated tumor that is often resistant to treatment. Various treatment options have been reported with no obvious gold standard. The purpose of this study was to compare treatment outcomes of conjunctival papilloma after various therapies
Methods: A retrospective chart review of 30 eyes of 30 patients diagnosed with conjunctival papilloma between 2009 to 2020 was performed. Data on demographics, tumor characteristics, primary treatment and outcomes were collected. The primary outcome was the frequency of complete tumor resolution and recurrence rate of each primary therapy. The secondary outcome was treatment related side effects.
Results: The mean age of the population was 57.5 years (3-93 years) with male predominance (n=22, 73.3%). Eleven eyes were treated with Interferon a-2b (IFN) (topical in 10, intralesional injection in 1 and, concomitant with cimetidine in 3 patients), seven with 5-fluorouracil (5FU) (topical in 6, injection in 1 and, concomitant with cimetidine in 6 patients), and 10 with excision biopsy and cryotherapy (6 with adjuvant therapy with IFN). No patients were treated with anti-viral therapy. The frequency of tumor resolution was 36.4% (4 of 11) in the IFN group, 28.5% (2 of 7) in the 5FU group, and 100% (10 of 10) in the surgery group, The mean time to resolution was faster in the surgical group compared to the medical group (1 day vs 159 days, p<0.001) but was similar between the IFN and 5FU groups (140 (21 to 210) vs 232 (135-330) days). There was a trend for a higher tumor recurrence with 33% in the surgical vs 0% in the medical group at 6 months and at 12 months, 67% recurrence in the surgical and 0% in the medical group. The mean time to recurrence 11.2 vs 24.3 months, p =0.18.
Conclusions: Papilloma resolution is faster with surgical excision as compared to medical therapy. However, recurrences are more frequent after surgery compared to medical treatment. Future studies are needed for more effective treatment modalities.
Disclosure: N
Support: NIH Center Core Grant P30EY014801, RPB Unrestricted Award, Dr Ronald and Alicia Lepke Grant, Lee and Claire Hager Grant, Robert Farr Family Grant, Grant and Diana Stanton-Thornbrough Grant, Robert Baer Family Grant, Roberto and Antonia Menendez Grant, Emilyn Page and Mark Feldberg Grant, Calvin and Flavia Oak Support Fund, Jose Ferreira de Melo Grant, The Richard and Kathy Lesser Grant, Michele and Ted Kaplan Grant, and Richard Azar Family Grant (institutional grants).
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