Current Practice in the Treatment of Epithelial and Melanocytic Tumours with Interferon-α2b: A Survey of Tertiary Eye Centres in Germany.

Purpose: To evaluate the standard of care, in particular the use of topical or subconjunctival interferon- α 2b, in treating ocular surface squamous neoplasia or melanocytic tumours in tertiary eye centres in Germany.
Methods: A survey containing 14 questions was sent to 43 tertiary eye centres in Germany. The questions addressed the surgical and medical management of ocular surface squamous neoplasia and melanocytic tumours (primary acquired melanosis and malignant melanoma), as well as the clinical experiences and difficulties in prescribing off-label interferon- α 2b eye drops and subconjunctival injections.
Results: Twenty-four tertiary eye centres responded to the survey. Eighty-three percent of centres had used interferon- α 2b in their clinical practice and 25% prescribed it as the first-line cytostatic agent following surgical excision of ocular surface squamous neoplasia, while 10% would do so for melanocytic tumours. Correspondingly, the majority of respondents selected mitomycin C as their first-line agent. Side effects were uncommon with topical interferon- α 2b eye drops but were more frequently reported after subconjunctival interferon- α 2b injections. In total, eight centres had experience with interferon- α 2b injections. The most significant obstacles perceived by ophthalmologists when prescribing interferon- α 2b were its high cost and the reimbursement thereof.
Conclusion: Off-label mitomycin C was the preferred adjuvant therapy for epithelial and melanocytic tumours, with interferon- α 2b being the standard second-line option. Interferon- α 2b has predominantly been used to treat ocular surface squamous neoplasia and, to a lesser extent, melanocytic tumours at German tertiary eye centres. Following its market withdrawal, supply shortages of interferon- α 2b are likely to have a profound impact on patient care and their quality of life.
Competing Interests: The authors declare that they have no conflict of interest. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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