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Author Spotlight: Anterior HR-OCT as a Non-Invasive Tool for Characterizing Ocular Surface Squamous Neoplasia
Published on: August 9, 2024
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Ocular Surface Squamous Neoplasia Masquerading as Recalcitrant Epithelial Keratitis
Arjun Watane1,2, Eric D Hansen1, Luis E Vazquez1
1Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL; and.
Cornea
|December 15, 2021
Summary
Ocular surface squamous neoplasia can mimic persistent toxic epithelial keratitis. High-resolution optical coherence tomography aids in diagnosing this rare condition, leading to effective topical chemotherapy treatment.
Area of Science:
- Ophthalmology
- Oncology
Background:
- Ocular surface squamous neoplasia (OSSN) is a rare malignant proliferation of the conjunctiva and cornea.
- It can present with varied clinical signs, sometimes mimicking benign conditions like toxic epithelial keratitis.
Observation:
- A 79-year-old male presented with symptoms suggestive of toxic epithelial keratitis refractory to treatment.
- Clinical examination revealed diffuse epitheliopathy and a thickened pinguecula.
- Anterior segment high-resolution optical coherence tomography (AS-HR-OCT) showed thickened, hyperreflective epithelium.
Findings:
- Incisional biopsy confirmed conjunctival and corneal intraepithelial neoplasia.
- The patient responded well to topical chemotherapy with 5-fluorouracil eye drops.
- Complete resolution of the ocular surface pathology was achieved.
Implications:
- OSSN can present atypically, challenging clinical diagnosis.
- AS-HR-OCT is a valuable non-invasive tool for diagnosing subtle OSSN.
- Prompt diagnosis and treatment with topical chemotherapy can lead to favorable outcomes.
