ANTERIOR SEGMENT OPTICAL COHERENCE TOMOGRAPHY FEATURES IN A CASE SERIES OF OCULAR SURFACE SQUAMOUS NEOPLASIA
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Abstract
Purpose: To describe anterior segment optical coherence tomography (AS-OCT) characteristics in a case series of ocular surface squamous neoplasia (OSSN) with varying grades of dysplasia confirmed by histopathology.
Methods: A case series of 10 eyes from 10 patients diagnosed with OSSN at the Cornea Department, Ho Chi Minh City Eye Hospital, in January 2026.
Results: Among 10 cases, 9/10 patients were male, with a mean age of 62 ± 16.16 years. Most patients had outdoor occupations (7/10), and 4/10 had a history of prior ocular surface surgery. The most common presenting symptom was foreign body sensation (4/10). Visual acuity ≥5/10 was observed in 5/10 cases. Lesions were predominantly located in the right eye (8/10), at the limbal conjunctival–corneal region (8/10), with a papilliform appearance in 6/10 cases.
On AS-OCT, all cases demonstrated epithelial thickening, hyperreflectivity, and an abrupt transition from normal to abnormal epithelium. Abnormalities at the epithelial–subepithelial interface were observed in 6/10 cases, corresponding histopathologically to severe dysplasia (2 cases) and squamous cell carcinoma (4 cases). Subepithelial alterations on AS-OCT correlated with histopathologic findings of parakeratosis (1 case), inflammatory tissue (1 case), and invasive atypical cells breaching the basement membrane (3 cases).
Conclusions: AS-OCT evaluation of epithelial, epithelial–subepithelial interface, and subepithelial changes on AS-OCT may help suggest the origin of the lesion and grade of dysplasia in OSSN. As a non-invasive and objective imaging modality, AS-OCT may also assist surgeons in preoperative planning.
Keywords
Ocular surface squamous neoplasia, anterior segment optical coherence tomography, conjunctival intraepithelial neoplasia, squamous cell carcinoma, dysplasia, histopathologic correlation
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References
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