Ophthalmic Plastic Surgery, Orbit and Ocular Oncology Services, LV Prasad Eye Institute, Hyderabad, Telangana, India.
Ophthalmic Pathology Laboratory, LV Prasad Eye Institute, Hyderabad, Telangana, India.
BMJ Case Rep. 2021 Jul 12;14(7):e243925. doi: 10.1136/bcr-2021-243925.
Corneal ocular surface squamous neoplasia usually begins at the limbus and presents as an avascular translucent sheet over the corneal surface. This case report describes a 67-year-old man with an unusual isolated, keratinous nodular corneal lesion. Slit-lamp examination showed an elevated, avascular, whitish plaque-like lesion at the central cornea surrounded by a normal corneal epithelium, with reduced visual acuity of 20/200 in the right eye. Anterior segment optical coherence tomography displayed a hyper-reflective, thickened epithelium with back shadowing. Histopathology showed keratinising hyperplastic stratified squamous epithelium with parakeratosis and moderate nuclear pleomorphism in lower second/third of epithelium suggestive of moderate dysplasia. His visual acuity returned to 20/20 after surgical excision but he developed multifocal corneal recurrences 6 weeks later, which were successfully managed with seven cycles of topical interferon immunotherapy. There are no recurrences observed at 6 months of follow-up.
角膜眼表面鳞状上皮肿瘤通常起始于角膜缘，表现为角膜表面上无血管的半透明片状物。本病例报告描述了一名 67 岁男性的一处罕见孤立性、角化性结节状角膜病变。裂隙灯检查显示在中央角膜处有一个隆起的、无血管的、灰白色斑块样病变，周围是正常的角膜上皮，右眼视力为 20/200。眼前节光学相干断层扫描显示上皮层增厚，呈高反射性，伴有后影。组织病理学显示角化过度的复层鳞状上皮增生，伴不全角化和中重度核异型性，提示中重度异型增生。手术切除后他的视力恢复到 20/20，但 6 周后出现多灶性角膜复发，经 7 个周期的局部干扰素免疫治疗后成功控制。随访 6 个月时未观察到复发。
