Corneal epithelial dysplasia after trifluridine use.
Prolonged topical trifluridine treatment of herpes simplex keratitis in three elderly patients produced slightly raised dysplastic corneal epithelial lesions. The involved epithelium had a ground-glass appearance and exhibited opaque cells, edema, and spindle-shaped surface cells. Histopathology demonstrated severe cellular atypism, loss of cell polarity, dyskeratosis, parakeratosis, and a few mitotic figures. The pathological change was apparently intraepithelial. After scraping, the edema and opaque cells in the regenerated epithelium gradually disappeared in 3-4 months on cessation of trifluridine therapy. In one patient recurrence of dendritic keratitis, 5 weeks after scraping, was treated by topical bromovinyldeoxyuridine eye drops. Since severe epithelial dysplasia may represent a precancerous condition, prolonged use of trifluridine should be avoided.
D000367:Age Factors; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001973:Bromodeoxyuridine / Q000008:administration & dosage / Q000031:analogs & derivatives; D003315:Cornea / Q000187:drug effects / Q000473:pathology; D003316:Corneal Diseases / Q000139:chemically induced*; D004848:Epithelium / Q000187:drug effects / Q000473:pathology; D006801:Humans; D007635:Keratitis, Dendritic / Q000188:drug therapy; D008297:Male; D008858:Microscopy, Phase-Contrast; D013936:Thymidine / Q000031:analogs & derivatives*; D014271:Trifluridine / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use
D000998:Antiviral Agents; C020235:brivudine; D001973:Bromodeoxyuridine; D014271:Trifluridine; D013936:Thymidine