Apport de la microscopie confocale par réflectance dans le diagnostic du mélanome conjonctival

Ronin, Catherine; Grivet, D.; Kaspi, Mathilde; Dumollard, Jean‐Marc; Douchet, C.; Thuret, Gilles; Gain, Philippe; Labeille, B.; Cinotti, Élisa; Perrot, Jean

doi:10.1016/j.annder.2016.10.012

Cited by 2 publications

(2 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, due to their limited ease of handling, both microscopes are used mostly to examine the cornea; rarely are they utilized for the conjunctiva or eyelid margin. Our group recently used a skin-specific, handheld reflectance confocal microscope in examination of the conjunctiva and presented preliminary data on its diagnostic accuracy. These pilot studies suggest that this device could be efficiently used for noninvasive diagnosis of conjunctival tumors.…”

Section: Introductionmentioning

confidence: 99%

Handheld In Vivo Reflectance Confocal Microscopy for the Diagnosis of Eyelid Margin and Conjunctival Tumors

et al. 2017

View full text Add to dashboard Cite

The clinical diagnosis of conjunctival and eyelid margin tumors is challenging, and new noninvasive imaging techniques could be valuable in this field. OBJECTIVE To assess the diagnostic accuracy of handheld in vivo reflectance confocal microscopy (IVCM) for the diagnosis of eyelid margin and conjunctival tumors. DESIGN A prospective observational study was conducted at University Hospital of Saint-Etienne from January 2, 2011, to December 31, 2016 (inclusion of patients until December 31, 2015, and follow-up until December 31, 2016). A total of 278 consecutive patients with eyelid margin or conjunctival lesions were included. Conjunctival lesions were diagnosed with a conventional clinical examination using a slitlamp and by handheld IVCM. Final diagnoses were established by histopathologic examination for 155 neoformations suspicious for being malignant through clinical and/or IVCM examination that were excised and on follow-up of 12 months or longer for the remaining 140 lesions. MAIN OUTCOMES AND MEASURES Sensitivity, specificity, and positive and negative predictive values for malignant tumors of the conjunctiva and eyelid margin were calculated using clinical examination with slitlamp and handheld IVCM. RESULTS In the 278 patients (136 [48.9%] females; mean [SD] age, 59 [21] years), a total of 166 eyelid margin and 129 conjunctival lesions were included in the analysis. Of the 155 excised neoformations with a histopathologic diagnosis, IVCM showed higher sensitivity compared with clinical examination conducted with the slitlamp for malignant tumors of the eyelid margin (98% vs 92%) and conjunctiva (100% vs 88%). The specificity for malignant eyelid margin tumors was higher for IVCM than for slitlamp examination (74% vs 46%), but slightly less for malignant conjunctival tumors (78% vs 88%). Analysis of all neoformations (155 excised and 140 in follow-up) confirmed these differences in the diagnostic accuracy of the clinical examination and IVCM. The presence of hyperreflective Langerhans cells mimicking malignant melanocytes was the main cause for misdiagnosis of malignant conjunctival tumors with IVCM. CONCLUSIONS AND RELEVANCE Handheld IVCM could be a useful tool for the identification of malignant conjunctival tumors. Further studies are required to confirm the usefulness of this device and identify possible features that can differentiate Langerhans cells from malignant melanocytes to prevent the misdiagnosis of melanoma using IVCM.

show abstract

Section: Introductionmentioning

confidence: 99%

Handheld In Vivo Reflectance Confocal Microscopy for the Diagnosis of Eyelid Margin and Conjunctival Tumors

et al. 2017

View full text Add to dashboard Cite

show abstract

“…IVCM has also been shown to have distinctive characteristics to help diagnose and differentiate conjunctival melanoma lesions. IVCM images of conjunctival melanoma typically show hyperreflective cells with prominent nucleoli, atypical large nuclei, tumor vessels and surrounding inflammation [31,32]. The IVCM images obtained by Cinotti et al with a handheld confocal microscope confirmed similar image findings of 10 conjunctival melanomas: melanoma lesions contained large >20 micron-sized round, hyperreflective cells as well as dendritic and pagetoid cells at the epithelial-stromal junction and/or stroma [21].…”

Section: Conjunctival Melanomamentioning

confidence: 68%

The role of imaging technologies for ocular surface tumors

Venkateswaran

Sripawadkul

Karp

2021

Current Opinion in Ophthalmology

View full text Add to dashboard Cite

Purpose of review This review will discuss the utility of high-resolution anterior segment optical coherence tomography (HR-OCT), in-vivo confocal microscopy (IVCM) and ultrasound biomicroscopy (UBM) in characterizing and diagnosing various ocular surface tumors, namely ocular surface squamous neoplasia (OSSN), conjunctival lymphoma and conjunctival melanoma. The strengths and limitations of each imaging modality will be discussed along with the characteristics findings of each lesion on each imaging platform.Recent findings HR-OCT can consistently be utilized in the clinic setting to distinguish between epithelial ocular surface tumors such as OSSN as compared with subepithelial tumors such as conjunctival lymphoma and conjunctival melanoma given their distinctive findings. IVCM can be used as an adjunct to HR-OCT to obtain cellular and surface characteristics, whereas UBM can be used to assess tumor depth and thickness for larger and highly pigmented lesions as well as to detect intraocular invasion.

show abstract

Apport de la microscopie confocale par réflectance dans le diagnostic du mélanome conjonctival

Cited by 2 publications

References 7 publications

Handheld In Vivo Reflectance Confocal Microscopy for the Diagnosis of Eyelid Margin and Conjunctival Tumors

Handheld In Vivo Reflectance Confocal Microscopy for the Diagnosis of Eyelid Margin and Conjunctival Tumors

The role of imaging technologies for ocular surface tumors

Contact Info

Product

Resources

About