Use of High-Resolution Optical Coherence Tomography in the Surgical Management of Ocular Surface Squamous Neoplasia: A Pilot Study

Karp, Carol L.; Mercado, Carolina; Venkateswaran, Nandini; Ruggeri, Marco; Galor, Anat; Garcia, Armando L; Sivaraman, K. R.; Fernandez, Maria Paula; Bermúdez, Antonio; Dubovy, Sander R.

doi:10.1016/j.ajo.2019.05.017

Cited by 27 publications

(20 citation statements)

References 49 publications

(92 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…High resolution (5–10 um) or ultra high resolution (3–5 um) spectral-domain OCT is useful in detecting epithelial thickness and differentiating epithelial from subepithelial lesions of the conjunctiva and cornea [ 38 , 39 ]. HR-OCT, therefore, provides an “optical biopsy” and can assist in diagnosis, plan for surgical management, and follow up during treatments particularly in patients who receive topical treatment for OSSN [ 16 , 40 , 41 ]. However, these instruments are not available in every eye-care setting and require experienced and skilled technicians.…”

Section: Discussionmentioning

confidence: 99%

Ocular surface squamous neoplasia in Northern Thailand: a 16-year review

et al. 2022

View full text Add to dashboard Cite

Purpose To evaluate clinical characteristics, treatments, and outcomes in patients with ocular surface squamous neoplasia (OSSN) at a tertiary center in Northern Thailand. Methods Patients diagnosed with either corneal-conjunctival intraepithelial neoplasia (CIN) or squamous cell carcinoma (SCC) from May 2000 to December 2015, were recruited. The patients’ demographics, symptoms, clinical characteristics, cytopathology, treatments, and outcomes were reviewed. Results Overall 171 eyes from 168 patients, 92 eyes were CIN and 79 eyes were SCC. Males were affected in 65.5%. The mean age was 58.8 ± 16.8 (29–99) years. In most cases (60.3%), the tumors were located at the limbus. The most common clinical characteristic was papilliform appearance (46.2%). Human immunodeficiency virus (HIV) infection was found in 37 (22.0%) patients with a mean age of 40.5 ± 7.7 years. The treatments and outcomes were evaluated in 136 eyes whose main initial treatment was wide excision with adjunctive cryotherapy (47.8%), followed by topical mitomycin C (30.9%). The mean follow-up time after treatment was 20.8 ± 2.2 (3–110) months and the recurrence occurred in 18 eyes (13.2%) during the follow-up period. The mean recurrence-free time (months) for CIN was significantly longer than that of SCC (81.3 ± 10.0 [95%CI 61.5 – 101.1] vs 33.2 ± 4.6 [95%CI 24.0 – 42.3], p = 0.030). SCC was the only significant risk factor that influences the recurrence of the tumors with the adjusted hazard ratio of 5.69 (p = 0.005). Conclusion OSSN in Northern Thailand usually involved a limbal area and presented as a papilliform mass. HIV infection should be suspected in young patients. CIN had better outcomes after treatments than invasive SCC.

show abstract

Section: Discussionmentioning

confidence: 99%

Ocular surface squamous neoplasia in Northern Thailand: a 16-year review

et al. 2022

View full text Add to dashboard Cite

show abstract

“…We found that measuring reflectivity can be an efficient way to differentiate eyes with LSCD from other aetiologies which may seem similar to LSCD. Previously, Karp et al utilised epithelial hyperreflectivity on OCT to diagnose cases of ocular surface squamous neoplasia [ 24 ]. Additionally, Liang et al described lower values of central corneal epithelial thickness and maximum limbal epithelial thickness on OCT as reliable parameters for confirmation of the diagnosis of LSCD [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

High-Resolution Optical Coherence Tomography Angiography Characteristics of Limbal Stem Cell Deficiency

et al. 2021

View full text Add to dashboard Cite

This study aimed to identify the anterior segment high-resolution optical coherence tomography (HR-OCT) and HR-OCT angiography (HR-OCTA) features suggestive of limbal stem cell deficiency (LSCD) as confirmed by both impression cytology (IC) and in vivo confocal microscopy (IVCM). This was a single-centre prospective cross-sectional study including 24 eyes of 22 patients with clinical suspicion of LSCD based on peripheral superficial corneal vascularisation and scarring. On IC and IVCM, performed and interpreted by blinded observers, 12 eyes each were diagnosed with and without LSCD. Additionally, 10 eyes of 5 healthy volunteers with no ocular pathology were also imaged. The 136 HR-OCT/A images of these 34 eyes were analysed with respect to 12 imaging parameters; the parameters most suggestive of LSCD were identified and the sensitivity and specificity were calculated. In the LSCD group, the most common aetiology was ocular chemical burns (83%), whereas in the non-LSCD group, the most common aetiology was viral keratitis (67%). Multiple logistic regression analysis revealed that mean epithelial reflectivity, mean stromal reflectivity, and mean superficial vascular density were the parameters that were diagnostic of LSCD on HR-OCT/A (p < 0.0001). A ratio of the mean epithelial reflectivity to stromal reflectivity of >1.29 corresponded with a high sensitivity (91.7%) and specificity (98.75%); while a mean superficial vascular density score of >0.38 corresponded with a sensitivity of 97.9% and specificity of 73.8%. In conclusion, HR-OCT/A as a non-invasive imaging modality could prove to be a useful tool for confirming the diagnosis of LSCD, with potential clinical and research applications.

show abstract

“…In addition, UHR-OCT is a useful method for differentiating thick tumoral lesions and squamous hyperactivity of the ocular surface from other ocular surface lesions, such as keratoconjunctivitis, pterygium, and Salzmann's nodular degeneration [53][54][55]. Intraoperative UHR-OCT aids in better visualization of tumor margins and guides surgical approaches for these lesions [56].…”

Section: Optical Coherence Tomography (Oct)mentioning

confidence: 99%

Imaging techniques for ocular neoplasia

Amiri¹,

Heidari²,

Jafari³

et al. 2022

Med Hypothesis Discov Innov Optom

View full text Add to dashboard Cite

Background: Novel ocular imaging modalities have greatly impacted the diagnosis and management of different types of ocular neoplasia. In this narrative review, we summarize the practical features of popular and novel imaging modalities for ocular tumors. Methods: Four databases, including PubMed/MEDLINE, Web of Science, Scopus, and Google Scholar, were searched from January 1, 2000 to August 31, 2022. Articles reporting different imaging modalities for diagnosing or monitoring treatment responses of ocular tumors were extracted using various combinations of the following keywords: ocular neoplasia, positron emission tomography or PET, single-photon emission computed tomography or SPECT, optical coherence tomography or OCT, OCT angiography or OCTA, computed tomography or CT, ultrasonography or US, ultrasound biomicroscopy or UBM, and magnetic resonance imaging or MRI. Results: Various ocular imaging modalities had different accuracies as adjunctive tools for detecting or managing ocular tumors. Anterior ultra-high-resolution optical coherence tomography (OCT) could be used to evaluate images with < 5-µm resolution. OCT angiography provided deeper insight into retinal vascular changes associated with the malignant transformation of choroidal melanoma. OCT in children altered the diagnosis of suspicious retinoblastoma in 3% of the cases and treatment plan in 11% of the cases. While positron-emission tomography (PET)/computed tomography (CT) allowed the detection of metastatic lesions of choroidal melanoma by full-body scanning, single-photon emission CT was more sensitive compared to PET in detecting choroidal melanoma. Ultrasound biomicroscopy, with an accuracy exceeding 92.5%, could detect retinal calcification in lesions measuring 2–3 mm. Magnetic resonance imaging (MRI) had better contrast compared to ultrasound biomicroscopy and higher sensitivity compared to CT in detecting post-laminar optic nerve invasion. However, MRI had a lower spatial resolution compared to OCT. Further development of imaging modalities and their application in drug development would improve the treatment of ocular tumors. Conclusions: Although diagnosing ocular tumors depend on clinical characteristics, innovations in ocular imaging have enabled early diagnosis and timely, appropriate management of ocular neoplasia, which are conducive to favorable visual outcomes and increased life expectancy. Further systematic reviews and meta-analyses of primary studies focusing on a specific imaging modality in ocular neoplasia could precisely determine the diagnostic accuracy of each imaging modality to better guide eye practitioners with efficient diagnostic or therapeutic approaches for these sight- or life-threatening entities. Imaging modalities may play a major role in drug development in the future.

show abstract

Use of High-Resolution Optical Coherence Tomography in the Surgical Management of Ocular Surface Squamous Neoplasia: A Pilot Study

Cited by 27 publications

References 49 publications

Ocular surface squamous neoplasia in Northern Thailand: a 16-year review

Ocular surface squamous neoplasia in Northern Thailand: a 16-year review

High-Resolution Optical Coherence Tomography Angiography Characteristics of Limbal Stem Cell Deficiency

Imaging techniques for ocular neoplasia

Contact Info

Product

Resources

About