June 2020
Volume 61, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2020
Ocular Surface Squamous Neoplasia Arising from Chronic Inflammation: A Case Series
Author Affiliations & Notes
  • Despoina Theotoka
    Ophthalmology , Bascom Palmer Eye Institute , Miami , Florida, United States
  • Sarah Wall
    Ophthalmology , Bascom Palmer Eye Institute , Miami , Florida, United States
  • Asaf Friehmann
    Ophthalmology , Bascom Palmer Eye Institute , Miami , Florida, United States
  • Anat Galor
    Ophthalmology , Bascom Palmer Eye Institute , Miami , Florida, United States
    Ophthalmology, Miami Veterans Administration Medical Center, Miami, Florida, United States
  • Carol Karp
    Ophthalmology , Bascom Palmer Eye Institute , Miami , Florida, United States
  • Footnotes
    Commercial Relationships   Despoina Theotoka, None; Sarah Wall, 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 Lee and Claire Hager Grant, The Virginia and Robert Farr 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, 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, 3274. doi:
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      Despoina Theotoka, Sarah Wall, Asaf Friehmann, Anat Galor, Carol Karp; Ocular Surface Squamous Neoplasia Arising from Chronic Inflammation: A Case Series. Invest. Ophthalmol. Vis. Sci. 2020;61(7):3274.

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

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Abstract

Purpose : Chronic inflammation has long been established as a predisposing factor to metaplastic changes as a cellular adaptation and ultimately to dysplasia. The ocular surface, with its presence of limbal stem cells, is susceptible to the same metaplastic and neoplastic changes and yet there is a paucity of literature on the development of ocular surface tumors in the setting of chronic inflammation. The purpose of this study is to identify and describe cases of ocular surface squamous neoplasia (OSSN) directly arising from chronic inflammatory states.

Methods : Four eyes from four patients were selected based on the presence of OSSN in the setting of chronic inflammation and availability of confirmatory histopathological analysis. All four eyes were initially referred with a presumptive diagnosis of benign corneal scarring. High resolution optical coherence tomography (HR-OCT) was performed in all cases. The presumptive clinical diagnosis was compared to diagnosis by HR-OCT findings and ultimately to definitive diagnosis by histopathology.

Results : Mean age of the patient population was 50±23 years with two patients aged 30 years or younger and two patients aged 65 years or older. Three of the four patients were male and all four of the patients identified as Caucasian. All four patients were originally referred for corneal scarring in the setting of chronic inflammatory conditions and were ultimately diagnosed with OSSN by HR-OCT findings and definitive histopathological analysis. One patient developed OSSN in the setting of contact lens-related acanthamoeba keratitis, two patients in the setting of ocular rosacea, and the remaining patient in the setting of herpes simplex virus (HSV) keratitis and juvenile ocular rosacea.

Conclusions : OSSN may be misdiagnosed as benign corneal scarring. In the setting of chronic inflammatory conditions, HR-OCT can be a key diagnostic tool in detecting atypical presentations of OSSN. Clinical suspicion should be high for neoplastic transformation in any patient who presents with ocular surface changes amidst a chronic inflammatory process.

This is a 2020 ARVO Annual Meeting abstract.

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