Ocular surface squamous neoplasia in India: a study of 438 patients

Kaliki, Swathi; Vempuluru, Vijitha S; Ghose, Neha; Gunda, Shruthi; Vithalani, Nidhi Mahendra; Sultana, Shahenaz; Ganguly, Anasua; Bejjanki, Kavya Madhuri; Jakati, Saumya; Mishra, Dilip Kumar

doi:10.1007/s10792-021-02189-y

Cited by 10 publications

(9 citation statements)

References 37 publications

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“…The epicentre of OSSN in our study was largely at the limbus and in the conjunctiva. This is in keeping with large studies and follows the pathophysiology of OSSN, which is thought to originate from the limbal stem cells [7,[13][14][15][16]. OSSN is also most commonly reported in the interpalpebral space, with the nasal quadrant mostly affected [14,15].…”

Section: Discussionsupporting

confidence: 84%

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

Hӧllhumer

Michelow

Williams

2023

Eye

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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.

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Section: Discussionsupporting

confidence: 84%

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

Hӧllhumer

Michelow

Williams

2023

Eye

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“…Higher levels of UV-B exposure in Malawi, Thailand, and India (with population-weighted average daily ambient UV radiation levels of 5,019 J/m 2 , 4,862 J/m 2 , and 4,514 J/m 2 , respectively) seem to correlate with the higher proportions of invasive disease in these regions, while Taiwan (2,908 J/m 2 ), which has similar levels of UV-B radiation to our population (3,206 J/m 2 ) had a comparable low rate of invasive disease to that of our study [12,22,[26][27][28]. However, this trend did not hold across all countries, as the recent New Zealand-based study by Hossain et al (2022) had higher rates of invasive disease despite substantially lower UV-B radiation (2,487 J/m 2 ), while Shields et al ( 2017) found significantly higher rates of invasive disease despite similar levels of radiation exposure (2,736 J/m 2 ) [11,18].…”

Section: Comparison Of Recent Retrospective Studies Of Clinicopatholo...supporting

confidence: 63%

“…UV-B radiation exposure also potentially plays a role in this trend [20]. The younger mean age of diagnosis in Malawi, Thailand, and India could potentially be explained by the higher rates of UV radiation exposure in these regions, a known pathogenic risk factor for OSSN development [22,[26][27][28]. Conversely, Taiwan had a comparable higher mean age of diagnosis to our study, reflecting the similar levels of UV-B radiation in that region [12].…”

Section: Demographic Trend Analysissupporting

confidence: 47%

Clinicopathological Correlates of Ocular Surface Squamous Neoplasia

Kalas,

Vagenas,

Maccheron

et al. 2024

Ocul Oncol Pathol

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Introduction: This study examined the distribution of histopathological disease severity amongst a cohort of patients treated for clinically suspected ocular surface squamous neoplasia and evaluated the relationship between various patient and clinical factors and the severity of pathological grade as well as treatment outcomes. Methods: A retrospective cohort study of demographic and clinicopathological factors of 150 patients clinically diagnosed with suspected ocular surface squamous neoplasia who underwent excision of lesion with histopathological diagnosis. Results: The study included 125 cases; the mean age at diagnosis was 64 years (SD = 11.26). 74% of cases were histologically confirmed as ocular surface squamous neoplasia. Pathological distribution was conjunctival intraepithelial neoplasia I (13.6%), conjunctival intraepithelial neoplasia II (16.8%), conjunctival intraepithelial neoplasia III (21.6%), carcinoma in situ (21.6%), and squamous cell carcinoma (2.4%). Lesion appearance was leukoplakic (18%), gelatinous (15%), dysplastic (11%), vascular (6%), papilliform (2%), nodular (2%). Lesion location was nasal (43%), temporal (42%), and superior or inferior (14%). Recurrence occurred in 7 cases (5.6%). A significant association was found between presence of leukoplakia and pathological grade (p = 0.05). Conclusions: Ocular surface squamous neoplasia is most frequently diagnosed in conjunctival intraepithelial neoplasia III and carcinoma in situ stages, and treatment outcomes are usually favourable.

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“…Primarily believed to be a disease of the elderly, there seems to be a wider range of age, with a recent large series from the Indian subcontinent reporting 49 years as the mean age at presentation (n=438) 18. Our cases too presented with OSSN at a much earlier age.…”

Section: Discussionmentioning

confidence: 51%

Corneal squamous neoplasia: masquerades and management outcomes at a rural eyecare centre

2023

Self Cite

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The authors describe two cases of corneal ocular surface squamous neoplasia (OSSN), presenting at our rural eyecare centre, which were initially misdiagnosed as viral epithelial keratitis and corneal pannus with focal limbal stem cell deficiency. Both the cases were refractory to initial treatment and corneal OSSN was suspected. Anterior segment-optical coherence tomography (AS-OCT) revealed a thickened, hyper-reflective epithelium with abrupt transition and an underlying cleavage plane, features typical of OSSN. Topical 1% 5-fluorouracil (5-FU) therapy was initiated and in two cycles (first case) to three cycles (second case), complete resolution was noted both clinically and on AS-OCT, with no significant side effects. Both patients are currently free of tumour at the 2-month follow-up period. The authors report the rare, atypical presentations of corneal OSSN, discuss the masquerades and highlight the role of primary topical 5-FU in managing corneal OSSN in limited resource settings.

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Ocular surface squamous neoplasia in India: a study of 438 patients

Cited by 10 publications

References 37 publications

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

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

Clinicopathological Correlates of Ocular Surface Squamous Neoplasia

Corneal squamous neoplasia: masquerades and management outcomes at a rural eyecare centre

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