June 2020
Volume 61, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2020
Anterior Segment High Resolution Optical Coherence Tomography (HR-OCT) as a Diagnostic Tool for Clinically Ambiguous Ocular Surface Lesions
Author Affiliations & Notes
  • Sarah Wall
    Bascom Palmer Eye Institute, Miami, Florida, United States
  • Despoina Theotoka
    Bascom Palmer Eye Institute, Miami, Florida, United States
  • Asaf Friehmann
    Bascom Palmer Eye Institute, Miami, Florida, United States
  • Anat Galor
    Bascom Palmer Eye Institute, Miami, Florida, United States
    V. A. Medical Center, Miami, Florida, United States
  • Carol Karp
    Bascom Palmer Eye Institute, Miami, Florida, United States
  • Footnotes
    Commercial Relationships   Sarah Wall, None; Despoina Theotoka, None; Asaf Friehmann, None; Anat Galor, None; Carol Karp, None
  • Footnotes
    Support  NIH Center Core Grant P30EY014801, RPB Unrestricted Award and Career Development Awards, The Dr. Ronald and Alicia Lepke Grant, The Virginia and Robert Farr Grant, The Lee and Claire Hager Grant, The Grant and Diana Stanton-Thornbrough Grant, The Robert Baer Family Grant, The Emilyn Page and Mark Feldberg Grant, The Jose Ferreira de Melo Grant, The Richard and Kathy Lesser Grant, The Michele and Ted Kaplan Grant, and the Richard Azar Family Grant (institutional grants).
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 396. doi:
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      Sarah Wall, Despoina Theotoka, Asaf Friehmann, Anat Galor, Carol Karp; Anterior Segment High Resolution Optical Coherence Tomography (HR-OCT) as a Diagnostic Tool for Clinically Ambiguous Ocular Surface Lesions. Invest. Ophthalmol. Vis. Sci. 2020;61(7):396.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Ocular surface lesions can be ambiguous and can thus present a diagnostic challenge, especially in the setting of concomitant ocular surface disease. The establishment of classic findings of ocular surface squamous neoplasia (OSSN) and other ocular surface lesions on anterior segment high resolution optical coherence tomography (HR-OCT) has greatly facilitated the differentiation of ocular surface pathologies. The purpose of this study was to evaluate the utility of HR-OCT as a tool in diagnosing ambiguous ocular surface lesions.

Methods : Thirteen eyes from thirteen patients were selected based on clinical ambiguity of their ocular surface lesion and availability of HR-OCT images. Five eyes were initially referred with a presumptive diagnosis of OSSN, six eyes with episcleritis or scleritis, and two eyes with melanoma. The clinical diagnosis was compared to diagnosis by HR-OCT findings and to definitive diagnosis by histopathology or culture.

Results : Mean age of the patient population was 54 ± 21.8 years, 46% of patients were male, and 77% of patients identified as Caucasian. Four of the five patients who initially presented with presumed OSSN were instead found by HR-OCT to have episcleritis, amelanotic melanoma, pterygium, and neuroma, all of which were confirmed histopathologically. In the fifth case the HR-OCT ruled out OSSN, and histopathology provided the final diagnosis of mycetoma. Six patients were clinically diagnosed with episcleritis or scleritis. Of those, three were found to have OSSN by HR-OCT findings and definitive histopathology. Another two eyes with presumed episcleritis were alternatively diagnosed with amelanotic melanoma and amyloidosis by HR-OCT and confirmed by histopathology. The final patient with suspected scleritis had inconclusive HR-OCT findings due to extensive inflammatory changes, requiring tissue analysis to ultimately diagnose OSSN. Two patients were referred with a presumed diagnosis of melanoma and after the HR-OCT suggested otherwise, histopathology and culture confirmed the lesions to be blue nevus and mycetoma, respectively.

Conclusions : HR-OCT was instrumental in arriving at a correct diagnosis in twelve of thirteen individuals with ambiguous ocular surface lesions. These findings support the use of HR-OCT as a powerful tool in the diagnosis of clinically ambiguous ocular surface lesions.

This is a 2020 ARVO Annual Meeting abstract.

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