Demographics, clinical presentation and risk factors of ocular surface squamous neoplasia at a tertiary hospital, South Africa

Abstract

Aims The aim of this study is to describe the demographic, presenting features and associated risk factors of ocular surface squamous neoplasia (OSSN) at a tertiary eye hospital in Johannesburg, South Africa. Methods An interventional prospective study of patients presenting with conjunctival masses was conducted. An electronic questionnaire was completed to document demographic data, presenting history, and associated risk factors. A slit lamp examination and photos were used to document and describe the clinical features at presentation. Cases (OSSN) and controls (benign lesions) were determined by histology. Results There were 130 cases and 45 controls. Median age was 44 years (IQR: 35–51) with an equal gender distribution in cases. The prevalence of HIV in cases was 74% and was strongly associated with OSSN (p < 0.001). Vascularisation, leukoplakia and pigmentation were clinical features that distinguished cases from controls. A fibrovascular morphology was strongly associated with a benign histology (p < 0.001), whereas leukoplakic and gelatinous morphologies were associated with OSSN. Conjunctival intra-epithelial neoplasia made up 82% of cases. Conclusion Our study describes a sample of OSSN that is young and has no gender predisposition. The majority of cases presented with CIN lesions, rather than SCC reported in other African countries. HIV was the most significant risk factor in this study population.

Yes-associated protein-1 overexpression in ocular surface squamous neoplasia; a potential diagnostic marker and therapeutic target

“…Frequency of YAP-1 expression in combined (preinvasive and invasive) OSSN (A) cases, YAP-1 nuclear staining intensity in combined OSSN (B). Previous research has found an association between OSSN and prolonged exposure to ultraviolet radiation, immunosuppression such as that caused by HIV/AIDS, Human papillomavirus infection, aging, chronic inflammation, tobacco use, and p53 mutations (1,49,60,60) but no study has considered a role of YAP-1 in OSSN. Given that YAP-1 is highly expressed in SCC from diverse body areas, it is intriguing to evaluate whether YAP-1 expression has a role in the etiology and progression of preinvasive to invasive OSSN.…”