Clinico-tomographic-pathological correlation in nodulo-ulcerative ocular surface squamous neoplasia: a study of 16 cases.

IF 1.4 4区医学 Q3 OPHTHALMOLOGY International Ophthalmology Pub Date : 2025-02-22 DOI:10.1007/s10792-024-03347-8

Vijitha S Vempuluru, Prerna Sinha, Suneetha Gavara, Saumya Jakati, Anshika Luthra, Swathi Kaliki

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Abstract

Objective: To describe the anterior segment optical coherence tomography (ASOCT) features of nodulo-ulcerative ocular surface squamous neoplasia (nuOSSN) and correlate these findings with histopathology.

Methods: Retrospective study of 16 eyes with nuOSSN with clinical images, ASOCT scans, and histopathology.

Results: The mean age at presentation was 55 years (median, 58 years; range, 25 to 81 years). Systemic predisposing factors included human immunodeficiency virus infection (n = 2, 13%) patients and xeroderma pigmentosum (n = 1, 6%). Bulbar conjunctiva was the most common epicenter (n = 10, 63%), with limbal and corneal extension seen in 16 (100%) and 14 (88%) eyes. In addition to epithelial thickening, typical of OSSN, scleral thinning, limbal thinning, and corneal thinning were seen in 5 (31%), 10 (63%), and 7 (44%) eyes of nuOSSN, respectively. Corneal stromal opacification with normal overlying epithelium was seen in 10 (63%) cases, corresponding to the 'wedge sign' on ASOCT in all 10 cases. This corresponded to stromal invasion of OSSN on histopathology in all eyes. The wedge sign had a sensitivity of 77%, specificity of 100%, positive predictive value of 100%, negative predictive value of 50%, and an accuracy of 81% for stromal invasion compared with the gold standard of histopathological examination.

Conclusion: The ASOCT features of nuOSSN differ from classic OSSN. nuOSSN is associated with adjacent areas of scleral/limbal/corneal thinning. Corneal stromal opacification is seen as a wedge sign on ASOCT and corresponds to corneal stromal tumor invasion on histopathology. Areas of scleral/limbal/corneal thinning, along with the 'wedge sign' on ASOCT, confirmed nuOSSN with stromal invasion in 63% of patients in this retrospective study.

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16例结节性溃疡性眼表鳞状瘤的临床-断层-病理相关性分析。

目的：描述结节性溃疡性眼表鳞状瘤变（nuOSSN）的前段光学相干断层扫描（ASOCT）特征，并将其与组织病理学联系起来。方法：回顾性分析16只眼的临床影像、ASOCT扫描及组织病理学。结果：患者就诊时平均年龄55岁(中位58岁；范围：25岁至81岁)。系统性易感因素包括人类免疫缺陷病毒感染（n = 2,13 %）患者和色素性干皮病（n = 1,6 %）。球结膜是最常见的震中（n = 10, 63%），角膜缘和角膜延伸分别见于16（100%）和14（88%）眼。除了上皮增厚外，典型的OSSN，巩膜变薄，角膜缘变薄和角膜变薄分别出现在5(31%),10（63%）和7（44%）只nuOSSN的眼睛中。10例（63%）角膜间质混浊伴正常上覆上皮，对应于所有10例ASOCT上的“楔形征”。在所有的眼组织病理学上，这与OSSN的间质浸润相对应。与组织病理学检查金标准相比，楔形征象对间质浸润的敏感性为77%，特异性为100%，阳性预测值为100%，阴性预测值为50%，准确性为81%。结论：nuOSSN的ASOCT特征不同于经典OSSN。nuOSSN与邻近的巩膜/角膜缘/角膜变薄有关。角膜间质混浊在ASOCT上被视为楔形征象，在组织病理学上与角膜间质肿瘤侵袭相对应。在这项回顾性研究中，63%的患者出现了巩膜/角膜缘/角膜变薄以及ASOCT上的“楔形征”，证实了nuOSSN伴间质浸润。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Ophthalmology OPHTHALMOLOGY-

CiteScore

3.20

自引率

0.00%

发文量

451

期刊介绍： International Ophthalmology provides the clinician with articles on all the relevant subspecialties of ophthalmology, with a broad international scope. The emphasis is on presentation of the latest clinical research in the field. In addition, the journal includes regular sections devoted to new developments in technologies, products, and techniques.