The Management of Ocular Surface Squamous Neoplasia (OSSN)

Abstract

The rise of primary topical monotherapy with chemotherapeutic drugs and immunomodulatory agents represents an increasing recognition of the medical management of ocular surface squamous neoplasia (OSSN), which may replace surgery as the standard of care in the future. Currently, there is no consensus regarding the best way to manage OSSN with no existing guidelines to date. This paper seeks to evaluate evidence surrounding available treatment modalities and proposes an approach to management. The approach will guide ophthalmologists in selecting the most appropriate treatment regime based on patient and disease factors to minimize treatment related morbidity and improve OSSN control. Further work can be done to validate this algorithm and to develop formal guidelines to direct the management of OSSN.

Novel automated non-invasive detection of ocular surface squamous neoplasia using artificial intelligence

“…Automated screening aims to detect and identify suspicious lesions on the ocular surface[ 62 ]. The integration of AI in automated screening for OSSN brings several advantages (Table 2 ).…”

“…However, enforcing AI-based treatment decisions may undermine the participation of the patient in the decision-making process, leading to poor acceptance of these treatment modalities and follow-up regimens, with overall less satisfaction and potential drop-out or loss to follow-up. For example, an AI algorithm might predict that a certain OSSN may respond better to Mitomycin C drops compared to interferon alpha 2B drops, but the ocular surface irritation caused by mitomycin drops may lead to poor compliance to this therapy leading to poor outcome and less patient satisfaction[ 62 ].…”