Prevalence of ocular surface squamous neoplasia in clinically diagnosed pterygium specimens: A systematic review and...

The purpose of the article was to determine the pooled prevalence of co-existing ocular surface squamous neoplasia (OSSN) among clinically diagnosed pterygium (PTG) specimens.A systematic review and meta-analysis were conducted using online databases to identify relevant articles up to May 2024. Eligible original studies that reported the prevalence of non-PTG and co-existing OSSN in clinically diagnosed PTG cases that underwent surgical excision and histopathological evaluation were included. Additionally, based on the geographical coordinates (latitude and longitude) of each study and the global skin pigmentation map, skin types were defined and included. A total of 21 cross-sectional studies consisting of 23,165 specimens from 22,921 patients were included. The pooled prevalence of non-PTG and co-existing OSSN diagnoses after excluding outlier results was 3.8% (95% CI: 1.9-5.8) and 3.7% (95% CI: 1.8-5.7), respectively. Studies from countries with predominantly medium skin pigmentation showed a significantly higher prevalence of co-existing OSSN (10.25% [95% CI: 8.1-12.45, P < 0.001]) compared to those from countries with predominantly white (2.45% [95% CI: 0.0-5.2, P = 0.008] or brown (3.1% [95% CI: 0.65-5.5, P = 0.01]) skin types. A positive association was also observed between regional altitude and co-existing OSSN prevalence (regression coefficient = 0.005, P < 0.001). In conclusion, pathological assessment of PTG specimens may be considered to avoid misdiagnosis and ensure appropriate management.