Intralesional bevacizumab use for invasive ocular surface squamous neoplasia

Purpose: Report the use of bevacizumab intralesional injection as an adjunctive therapy in a patient with ocular surface squamous neoplasia (OSSN) after an incomplete response to topical and intralesional chemotherapy. Methods: This is a case report of a 79-year-old man who was treated with topical and intralesional chemotherapy (interferon-alpha-2b, mitomycin-C, and 5-fluorouracil) over 22 months with incomplete resolution of severe OSSN. Intralesional bevacizumab was tried as an adjuvant treatment to resolve the residual tumor. Results: Grossly and histologically there was no significant change in the residual tumor after treatment with intralesional bevacizumab. Conclusions: While intralesional bevacizumab has been utilized as a treatment modality in the use of other squamous tumors, further studies on the use of bevacizumab in squamous neoplasia would be needed to recommend this treatment for the ocular surface. In the absence of further studies, the current topical and intralesional chemotherapeutic agents should continue to be the mainstay of medical treatment for squamous neoplasia; surgical management is still the definitive treatment.