Clinical and histopathological characteristics of ocular surface squamous neoplasia: Evidence from a tertiary eye care center, northwest Ethiopia

Abstract

Background: Ocular surface squamous neoplasia is a spectrum of diseases encompassing from mild dysplasia to invasive squamous cell carcinoma of the ocular surface.Patients and methods: A series of 50 cases with suspected ocular surface squamous neoplasia presenting to Gondar University Hospital Tertiary Eye Care and Training Center, Northwest Ethiopia from January 2015 to June 2016 were enrolled. Clinical parameters were documented through interviewer administered questionnaire and ocular examination. Excisional or incisional biopsy was done on suspected conjunctival lesions and sent for histopathology examination to an experienced pathologist. Statistical Packages for Social Sciences version 21 was used to analyze data.Results: Mean age of the participants was 41.26 years (age range 18-75) and 72% of the cases were males. Majority of the participants were farmers (40%). Human immunodeficiency virus (HIV) was positive in 22% of the participants. Leukoplakic appearance was the commonest (68%) and nasal side of the conjunctiva was the commonest location of the lesions (72%). Feeding vessels were observed in 84% of the participants. Histopathological examination revealed ocular surface squamous neoplasia in 96% of the participants. Among these 36% had carcinoma in situ, 36% had invasive squamous cell carcinoma, 18% had conjunctival/corneal intraepithelial neoplasia and 10% had associated pterygium clinically and on histology as well. Conclusion and recommendations:Almost all the clinically suspected OSSN lesions were actual OSSN in histology. Most of the ocular surface squamous neoplasia cases in the study were non-HIV positive young males and had the lesion on their nasal side of the globe. Despite the age of the patient and status of HIV infection it is good to subject suspected OSSN lesions for histopathological examination. Most of the patients were farmers and the role of other risk factors need to be considered and large-scale studies are recommended in Ethiopia and other African countries in the future.

Clinicopathological characteristics of ocular surface squamous neoplasia: a 10-year review form a referral tertiary centre in Nigeria

“…The peak age group of patients affected by OSSN was 30-39 years, slightly younger than the general average age of OSSN that have been reported in Nigeria and across sub-Saharan Africa which is usually in the 40-49 years age group. [13][14][15] However, in keeping with previous reports, the condition occurs in a much younger age group in our patients as compared to studies in Caucasian populations and this has been attributed to the higher association of OSSN cases in the tropics with HIV/AIDS. [2,3,16,17] This study reveals a predominant affectation of males in disagreement with early observations across sub-Saharan Africa where an equal sex prevalence was generally reported.…”

“…[3,18,19] However, some recent studies have revealed a male predominance for OSSN in sub-Saharan Africa. [13,14] These variations in sex prevalence are probably related to differences in study design as most of the single institution-based studies show a male predominance whereas the larger scale studies show an equal sex distribution. A female predominance has also been reported in occasional studies, [20] again highlighting the selection bias inherent in single institution-based studies.…”

“…This nding generally agrees with most other studies from within Africa but is in contrast to a study from Asia where gelatinous appearance was more predominant. [13,21,23] This nding suggests a possible racial/ethnic variation in clinical appearance of OSSN but this will need to be validated by more large scale, comparative studies.…”