Vempuluru Vijitha S, Sinha Prerna, Gavara Suneetha, Jakati Saumya, Luthra Anshika, Kaliki Swathi
The Operation Eyesight Universal Institute for Eye Cancer, L.V. Prasad Eye Institute, Hyderabad, Telangana, 500034, India.
Ophthalmic Pathology Laboratory, L.V. Prasad Eye Institute, Hyderabad, Telangana, 500034, India.
Int Ophthalmol. 2025 Feb 22;45(1):81. doi: 10.1007/s10792-024-03347-8.
To describe the anterior segment optical coherence tomography (ASOCT) features of nodulo-ulcerative ocular surface squamous neoplasia (nuOSSN) and correlate these findings with histopathology.
Retrospective study of 16 eyes with nuOSSN with clinical images, ASOCT scans, and histopathology.
The mean age at presentation was 55 years (median, 58 years; range, 25 to 81 years). Systemic predisposing factors included human immunodeficiency virus infection (n = 2, 13%) patients and xeroderma pigmentosum (n = 1, 6%). Bulbar conjunctiva was the most common epicenter (n = 10, 63%), with limbal and corneal extension seen in 16 (100%) and 14 (88%) eyes. In addition to epithelial thickening, typical of OSSN, scleral thinning, limbal thinning, and corneal thinning were seen in 5 (31%), 10 (63%), and 7 (44%) eyes of nuOSSN, respectively. Corneal stromal opacification with normal overlying epithelium was seen in 10 (63%) cases, corresponding to the 'wedge sign' on ASOCT in all 10 cases. This corresponded to stromal invasion of OSSN on histopathology in all eyes. The wedge sign had a sensitivity of 77%, specificity of 100%, positive predictive value of 100%, negative predictive value of 50%, and an accuracy of 81% for stromal invasion compared with the gold standard of histopathological examination.
The ASOCT features of nuOSSN differ from classic OSSN. nuOSSN is associated with adjacent areas of scleral/limbal/corneal thinning. Corneal stromal opacification is seen as a wedge sign on ASOCT and corresponds to corneal stromal tumor invasion on histopathology. Areas of scleral/limbal/corneal thinning, along with the 'wedge sign' on ASOCT, confirmed nuOSSN with stromal invasion in 63% of patients in this retrospective study.
描述结节性溃疡性眼表鳞状上皮肿瘤（nuOSSN）的眼前节光学相干断层扫描（ASOCT）特征，并将这些发现与组织病理学结果相关联。
对16例患有nuOSSN的患者进行回顾性研究，收集其临床图像、ASOCT扫描结果和组织病理学资料。
患者就诊时的平均年龄为55岁（中位数为58岁；范围为25至81岁）。全身易感因素包括人类免疫缺陷病毒感染（n = 2，13%）和着色性干皮病（n = 1，6%）。球结膜是最常见的发病中心（n = 10，63%），16只（100%）眼睛出现角膜缘和角膜受累，14只（88%）眼睛出现角膜受累。除了OSSN典型的上皮增厚外，nuOSSN患者中分别有5只（31%）、10只（63%）和7只（44%）眼睛出现巩膜变薄、角膜缘变薄和角膜变薄。10例（63%）患者可见角膜基质混浊且上皮正常，所有10例在ASOCT上均表现为“楔形征”。在所有眼中，这与组织病理学上OSSN的基质浸润相对应。与组织病理学检查的金标准相比，楔形征对基质浸润的敏感性为77%，特异性为100%，阳性预测值为100%，阴性预测值为50%，准确率为81%。
nuOSSN的ASOCT特征与经典OSSN不同。nuOSSN与巩膜/角膜缘/角膜变薄的相邻区域相关。角膜基质混浊在ASOCT上表现为楔形征，在组织病理学上对应于角膜基质肿瘤浸润。在这项回顾性研究中，巩膜/角膜缘/角膜变薄区域以及ASOCT上的“楔形征”在63%的患者中证实了nuOSSN伴基质浸润。
