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Presentation type	E-poster
Title	Photographical overview of successful treatment of PAM with severe atypia using topical MMC

Purpose	We present a photographical overview of successful treatment of PAM with severe atypia using topical MMC 0.02%
Methods	One patient was consecutively treated with 3 cycles of topical 5FU 1% and MMC 0.02% for PAM with severe atypia
Results	A 69-year-old man presented with an extensive flat pigmentation of the left limbal and bulbar conjunctiva, extending into the corneal epithelium. A clinical diagnosis of PAM was made. Due to the unavailability of topical MMC, the patient underwent initial treatment with 3 cycles of topical 5-FU 1%. After 2 cycles our patient presented with a corneal epithelial defect and a remarkable conjunctival epithelial defect overlying one zone of PAM. Unfortunately, even after 3 cycles there was only a mild decrease in pigmentation. Subsequently, a conjunctival map biopsy was performed. Pathology confirmed the diagnosis of PAM with severe atypia. Since 50% of PAM with severe atypia evolves into a malignant melanoma, the patient underwent adjuvant therapy with 3 cycles of topical MMC 0.02% (which was at that time available again). After each cycle, a progressive reduction of the conjunctival and corneal pigmentation was noticed. One year after therapy near complete regression of PAM was observed.
Conclusion	In extensive PAM with severe atypia, topical chemotherapy is the mainstay of treatment. This photographical overview shows the effect of topical MMC as a successful treatment of extensive PAM with severe atypia. Previous treatment with topical 5FU was less effective compared to MMC and resulted in a severe ocular surface toxicity.
Conflict of interest	No

Authors 1

Last name	BATENS
Initials	M
Department	UGent / UZ Gent
City	Gent

Authors 2

Last name	Roels
Initials	D
Department	UGent / UZ Gent
City	Gent