Cytological Evaluation in the Diagnosis and Management of Ocular Surface Neoplasia

Abstract

Abstract: : Purpose: To evaluate the use of cytology in the diagnosis and management of patients with ocular surface neoplasia. Methods: Ocular cytological technique was used in 25 patients, 14 patients with suspected squamous cell neoplasia and in 11 patients with pigmented conjunctival tumors. Cells were scraped from the surface of various conjunctival and corneal lesions with a blunt platinum spatula, immediately smeared onto glass slides and fixed in 95% ethyl alcohol solution. The slides were stained with hematoxylin and eosin prior to light microscopic examination. Results: Cytological evaluation of the material obtained by the scraping procedure showed dysplastic and dyskeratotic cells in the areas of clinical suspicion. This method was valuable in making an initial rapid diagnosis, in detection of recurrences and in the follow–up care of patients on topical chemotherapy. Ocular cytological examination was not as useful in patients with pigmented tumors as it was in squamous cell lesions. Conclusions: Ocular surface cytological technique can be used to obtain diagnostic material, as an aid in detecting recurrences of neoplastic processes and in the follow–up of patients on topical chemotherapeutic agents. Limitations include inability to assess depth of the lesion and the potential lack of skilled experience in both acquiring adequate cellular specimens and rendering accurate cytopathologic diagnoses. While this technique is very useful in the diagnosis and follow–up of patients with squamous cell lesions, it is less applicable to pigmented conjunctival tumors that tend to be more subepithelial in location.

Keywords: pathology techniques • cytology • oncology