A case of sight threatening complications from topical 1% 5-fluorouracil in the treatment of ocular surface squamous neoplasia

Weijie Violet Lin; Gabriel M Rand; Michael L Miller; Brian P Marr; Leejee H Suh

doi:10.1016/j.ajoc.2022.101265

A case of sight threatening complications from topical 1% 5-fluorouracil in the treatment of ocular surface squamous neoplasia

Am J Ophthalmol Case Rep. 2022 Jan 20:25:101265. doi: 10.1016/j.ajoc.2022.101265. eCollection 2022 Mar.

Authors

Weijie Violet Lin¹, Gabriel M Rand¹, Michael L Miller², Brian P Marr¹, Leejee H Suh¹

Affiliations

¹ Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA.
² Department of Pathology and Cell Biology, Division of Neuropathology, Columbia University Medical Center, New York, NY, USA.

Abstract

Purpose: 1% topical 5-fluorouracil (5-FU) is a treatment for ocular surface squamous neoplasia (OSSN) due to its effectiveness, low cost, and tolerable side effect profile. To our knowledge there is no reported sight-threatening corneal complication of 1% 5-FU for the treatment of OSSN.

Observations: We report a 78 year-old man with bilateral conjunctival intraepithelial neoplasia (CIN) who developed bilateral corneoscleral ulceration and corneal perforation of the left eye after 1% 5-FU topical treatment.

Conclusions and importance: Our case report describes serious potential complications of 1% 5-FU, reviews possible risk factors associated with poor outcomes, and discusses our treatment approach.

Keywords: 5-Fluorouracil; Conjunctival intraepithelial neoplasia; Cornea; Corneal perforation; Corneal ulceration; Ocular surface squamous neoplasia.

Publication types

Case Reports