Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami, Miami, FL, USA; Department of Ophthalmology and Visual Science, Yale School of Medicine, New Haven, CT, USA.
Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami, Miami, FL, USA; Department of Ophthalmology, Miami Veterans Administration Medical Center, Miami, FL, USA.
Ocul Surf. 2022 Apr;24:74-82. doi: 10.1016/j.jtos.2022.02.003. Epub 2022 Feb 26.
Ocular surface masqueraders encompass any ocular surface lesion masquerading as another ocular surface lesion. High resolution optical coherence tomography (HR-OCT) has emerged as an adjunctive tool to clinical acumen. This study's purpose is to evaluate the utility of HR-OCT images in guiding the diagnosis and management of those lesions.
22 individuals with a clinically ambiguous ocular surface lesion with slit lamp photographs (SLP), HR-OCT images, and histopathological examination were included in the study. The presumptive clinical diagnosis based on SLP was compared to the diagnosis suggested by HR-OCT findings and to definitive diagnosis by histopathology. The main outcome of this study was the frequency in which HR-OCT findings guided the clinician to the correct diagnosis.
7 lesions were epithelial, 3 had an epithelial and a subepithelial component, and 12 were subepithelial. HR-OCT was most effective in discerning lesion location, successfully identifying the location in 100% of cases. Classic HR-OCT findings were detected in 68.2% of cases while suggestive features were detected in 31.8% of cases. The epithelial lesions' mean epithelial thickness was 265.4 ± 140.6 μm, the subepithelial lesions' mean was 58.0 ± 25.0 μm, and the combined lesions' mean was 140.0 ± 70.0 μm. The epithelium was significantly thicker in epithelial lesions compared to subepithelial and combined lesions. By ROC analysis we identified that using a cut off of 156 μm, the sensitivity was 86% and the specificity was 93%.
HR-OCT can be a valuable diagnostic tool, assisting in the differentiation of ambiguous ocular surface pathologies by providing a cross-sectional, morphological image of the lesion.
眼表伪装者包括任何伪装成另一种眼表病变的眼表病变。高分辨率光学相干断层扫描（HR-OCT）已成为临床敏锐度的辅助工具。本研究的目的是评估 HR-OCT 图像在指导这些病变的诊断和治疗中的效用。
本研究纳入了 22 名具有临床意义不明确的眼表病变患者，这些患者具有裂隙灯照片（SLP）、HR-OCT 图像和组织病理学检查。基于 SLP 的假定临床诊断与 HR-OCT 结果提示的诊断以及组织病理学的明确诊断进行比较。本研究的主要结果是 HR-OCT 结果引导临床医生做出正确诊断的频率。
7 个病变为上皮性，3 个病变具有上皮和上皮下成分，12 个病变为上皮下。HR-OCT 最有效地辨别病变位置，成功识别了 100%的病例。在 68.2%的病例中检测到经典 HR-OCT 发现，在 31.8%的病例中检测到提示性特征。上皮病变的平均上皮厚度为 265.4±140.6μm，上皮下病变的平均厚度为 58.0±25.0μm，混合病变的平均厚度为 140.0±70.0μm。上皮病变的上皮厚度明显高于上皮下病变和混合病变。通过 ROC 分析，我们确定使用 156μm 的截断值时，敏感性为 86%，特异性为 93%。
HR-OCT 可以成为一种有价值的诊断工具，通过提供病变的横截面、形态学图像，帮助区分模糊的眼表病理学。
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