The Diagnostic Value of Exfoliative Cytology vs Histopathology for Ocular Surface Squamous Neoplasia

Semenova, Ekaterina A.; Milman, Tatyana; Finger, Paul T.; Natesh, Sribhargava; Kurli, Madhavi; Schneider, Susan; Iacob, Codrin; McCormick, Steven A.

doi:10.1016/j.ajo.2009.06.015

Cited by 29 publications

(14 citation statements)

References 23 publications

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“…Other technologies that can be used to identify OSSN in the setting of coexistent ocular pathology include exfoliative cell cytology [30,31], papanicolau [32], impression cytology [33–35]), in vivo staining [36,37], and in vivo confocal microscopy [38–41]. While all can play a role in the diagnosis of OSSN, HR-OCT stands out with several advantages in that it is noninvasive, easily scans the entire ocular surface, and requires minimal operator training and no need for laboratory processing.…”

Section: Discussionmentioning

confidence: 99%

Role of high resolution optical coherence tomography in diagnosing ocular surface squamous neoplasia with coexisting ocular surface diseases

et al. 2017

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Purpose Coexistence of an ocular surface disease can mask the typical features of ocular surface squamous neoplasia (OSSN). The purpose of this study was to evaluate high resolution optical coherence tomography (HR-OCT) as an adjunct in the detection and differentiation of OSSN within coexisting ocular surface pathologies. Methods Retrospective study of 16 patients with ocular surface disease and lesions suspicious for OSSN that were evaluated with HR-OCT. HR-OCT images of the lesions were taken to look for evidence of OSSN. Biopsies were performed in all cases, and the HR-OCT findings were compared to the histological results. Results Of the 16 patients with OSSN and a coexisting ocular surface disease, 12 were found to have OSSN by HR-OCT and all were subsequently confirmed by biopsy. Two patients had OSSN with rosacea, one with pingueculum, two within pterygia, one with Salzmann’ nodular degeneration, six with limbal stem cell deficiency (LSCD)/scarring. In all 12 cases HR-OCT images revealed classical findings of hyper-reflective, thickened epithelium and an abrupt transition from normal to abnormal epithelium. OSSN was ruled out by HR-OCT in four cases (2 Salzmann’s, 1 mucous membrane pemphigoid, and 1 LSCD). Negative findings were confirmed by biopsy. HR-OCT was used to follow resolution of the OSSN in positive cases, and it detected recurrence in 1 case. Conclusions While histopathology is the gold standard in the diagnosis of OSSN, HR-OCT can be used to noninvasively detect the presence of OSSN in patients with coexisting ocular conditions.

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Section: Discussionmentioning

confidence: 99%

Role of high resolution optical coherence tomography in diagnosing ocular surface squamous neoplasia with coexisting ocular surface diseases

et al. 2017

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“…Careful preparation and immediate analysis after tissue sampling are crucial for obtaining reliable results. [83] In vivo confocal microscopy[84,85] is another way to morphologically assess individual cells for dysplasia or neoplasia, but its use requires substantial technical expertise. The efficacy of confocal microscopy in the diagnosis of OSSN has been variable, and discerning neoplasia on confocal microscopy is challenging.…”

Section: Diagnostic Modalitiesmentioning

confidence: 99%

Diagnosis and medical management of ocular surface squamous neoplasia

Sayed-Ahmed

Palioura

Galor

et al. 2016

Expert Review of Ophthalmology

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Introduction Topical chemotherapy has gained popularity among clinicians for the treatment of ocular surface squamous neoplasia (OSSN). The principal topical chemotherapy agents used in the management of OSSN are interferon-α2b, 5-fluorouracil, and mitomycin C. High-resolution optical coherence tomography (HR-OCT) is a non-invasive technique that can differentiate OSSN from other ocular surface lesions. Areas covered This review highlights the current regimens and diagnostic modalities used in managing OSSN. A review of the literature was performed using the keywords “conjunctival intraepithelial neoplasia”, “ocular surface squamous neoplasia”, “optical coherence tomography”, “interferon-α2b”, “5-fluorouracil” and “mitomycin C”. Expert commentary Topical chemotherapy for OSSN can be used as primary therapy, for chemoreduction prior to surgical excision, and postoperatively to prevent tumor recurrence. It has the advantage of treating microscopic disease as well as large tumors. HR-OCT provides an “optical biopsy” that can assist in diagnosis and guide management of OSSN lesions.

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“…The mean accuracies of clinical and pathologic diagnosis were 0.84 and 0.98, respectively 13,15,16,27,38,40,45 . The risk of positive margins following excision was estimated at 0.42 13,15,27,34,45,48 .…”

Section: Resultsmentioning

confidence: 95%

Surgery Versus Interferon Alpha-2b Treatment Strategies for Ocular Surface Squamous Neoplasia

Siedlecki

Tapp

Tosteson

et al. 2016

Cornea

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Purpose To compare treatment strategies for ocular surface squamous neoplasia (OSSN), ranging from surgical excision to empiric topical interferon alpha-2b (IFN-α2b). Methods A decision model was constructed to determine which of four treatment strategies minimized expected persistence/recurrence of disease in patients with OSSN: excision followed by repeat excision for positive surgical margins, excision followed by IFN-α2b for positive margins, incisional biopsy followed by IFN-α2b for positive biopsies, and empiric treatment with IFN-α2b. Probabilities were estimated from literature published between 1983 and 2015. Expected values for the probability of recurrence could range from 0 (no persistence/recurrence) to 1 (persistence/recurrence). Sensitivity analyses were performed for each variable. Results Excision followed by IFN-α2b for positive margins was estimated to minimize persistence/recurrence of OSSN (EV 0.13 versus 0.17 for empiric IFN-α2b, 0.22 for excision-only, and 0.30 for incisional biopsy-directed IFN-α2b). The optimal strategy was sensitive to three variables: efficacy of IFN-α2b, recurrence following negative surgical margins, and accuracy of excisional biopsy. Conclusions In our decision analysis using studies published between 1983 and 2015, surgical excision followed by IFN-α2b for positive margins is the favored strategy for minimizing persistence/recurrence of OSSN. Future prospective studies would add to the certainty of these conclusions.

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The Diagnostic Value of Exfoliative Cytology vs Histopathology for Ocular Surface Squamous Neoplasia

Cited by 29 publications

References 23 publications

Role of high resolution optical coherence tomography in diagnosing ocular surface squamous neoplasia with coexisting ocular surface diseases

Role of high resolution optical coherence tomography in diagnosing ocular surface squamous neoplasia with coexisting ocular surface diseases

Diagnosis and medical management of ocular surface squamous neoplasia

Surgery Versus Interferon Alpha-2b Treatment Strategies for Ocular Surface Squamous Neoplasia

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