Ferraz Flávia Benchimol, Castelo Branco Ana Marisa Pires, da Cruz Luiz Guilherme Ito, Fernandes Bruno F, Morales Melina Correia, Neto Rubens Belfort, Fernandes Arthur Gustavo
Department of Visual Sciences and Ophthalmology, Federal University of São Paulo, São Paulo, SP, Brazil.
Department of Ophthalmology, Argumento Institute, Boucherville, QC, Canada.
Eur J Ophthalmol. 2024 May;34(3):859-863. doi: 10.1177/11206721231204188. Epub 2023 Sep 24.
To compare the use of toluidine blue 1% eye drops with anterior segment optical coherence tomography (OCT) for the determination of tumour margins in patients with ocular surface squamous neoplasia (OSSN).
The study was conducted from July 2020 to June 2021 at the Ocular Oncology department at the Federal University of São Paulo, Brazil. Slit-lamp photographs after toluidine blue staining and OCT of the anterior segment were taken on the same day from patients with OSSN. Photographs and OCT images were analyzed quantitatively using the software ImageJ and IMAGEnet®, respectively. The agreement between techniques was evaluated qualitatively through the Bland-Altman graph and quantitatively through intraclass correlation (ICC).
A total of 21 participants (71.43% males) with a clinical diagnosis of OSSN were included in the study. The average + SD diameter along the chosen axes was 4.43 ± 2.08 mm with OCT of 4.37 ± 2.03 mm with toluidine blue, a difference not statistically significant (p = 0.2891). The Bland-Altman analysis indicated a good qualitative agreement between the methods, with all cases inserted within the limits of agreement from -0.3217 to 0.4268. The ICC quantitative analysis showed an almost perfect agreement of 99.57% (95%CI: 98.96-99.83%; p < 0.001).
Our findings showed that OCT and toluidine eye drops are equivalent in determining margins for tumour measurements, which is particularly relevant in low-income settings where anterior segment OCT is not available. The use of toluidine blue 1% could be an useful alternative to quantify the size of the tumour, help to monitor tumour growth, and outline margins for surgical planning.
比较1%甲苯胺蓝滴眼液与眼前节光学相干断层扫描（OCT）在确定眼表鳞状上皮肿瘤（OSSN）患者肿瘤边界方面的应用。
该研究于2020年7月至2021年6月在巴西圣保罗联邦大学眼科肿瘤科进行。同一天对OSSN患者进行甲苯胺蓝染色后的裂隙灯照相及眼前节OCT检查。分别使用ImageJ软件和IMAGEnet®软件对照片和OCT图像进行定量分析。通过Bland-Altman图对技术间的一致性进行定性评估，通过组内相关系数（ICC）进行定量评估。
本研究共纳入21例临床诊断为OSSN的参与者（71.43%为男性）。沿选定轴的平均直径（平均值±标准差），OCT测量为4.43±2.08mm，甲苯胺蓝测量为4.37±2.03mm，差异无统计学意义（p = 0.2891）。Bland-Altman分析表明两种方法在定性上具有良好的一致性，所有病例均落在-0.3217至0.4268的一致性范围内。ICC定量分析显示一致性几乎完美，为99.57%（95%CI：98.96 - 99.83%；p < 0.001）。
我们的研究结果表明OCT和甲苯胺蓝滴眼液在确定肿瘤测量边界方面等效，这在无法获得眼前节OCT的低收入环境中尤为重要。1%甲苯胺蓝的使用可能是一种有用的替代方法，可用于量化肿瘤大小、帮助监测肿瘤生长以及为手术规划勾勒边界。
