Abstract
Purpose :
The ability to diagnose ocular surface neoplasia with the aid of imaging modalities is improving but still hindered by the limitations of currently available techniques. Inverse spectroscopic optical coherence tomography (IS-OCT) is an emerging technique capable of detecting nanoscale ultrastructural differences in pre-neoplastic and neoplastic tissues. We previously detected significant differences between ocular surface squamous neoplasia and pterygium ex vivo, and we herein aimed to apply this imaging technique in vivo to aid in differentiating ocular surface lesions in patients.
Methods :
Patients 12 years and older diagnosed with ocular surface pigmentation or lesions were consented and enrolled. IS-OCT was performed using a custom-built visible and near-infrared light OCT (vnOCT) device. The D value, which is a measure found previously to be associated with neoplasia, was calculated and compared between sample types.
Results :
Three subjects received a clinical diagnosis of complexion-associated melanosis (CAM). Two subjects received a clinical diagnosis of primary acquired melanosis (PAM). The ages of these subjects ranged from 63-84 and 41-54 years in the CAM and PAM groups, respectively. All five subjects were non-Hispanic. The three CAM subjects were African Americans, one PAM subject was Asian and the other PAM subject declined to state their race. The average D value in imaged areas of CAM was 2.6 ± 0.2 (n = 3) vs. 3.6 ± 0.2 (n = 2) in PAM (p = 0.02). Figure 1 shows a representative en face heat-map of D in CAM vs. PAM. One of the PAM subjects underwent excisional biopsy of their lesions, and the area that showed PAM with mild atypia had D = 3.4 vs. 2.4 in the area of PAM without atypia.
Conclusions :
Our results show that IS-OCT was successfully used to image conjunctival lesions in vivo for the first time. Our data also suggest the possibility that IS-OCT could help detect cellular atypia in melanotic lesions. However, further investigation is required with additional samples and correlation with pathologic diagnostic findings to confirm the capability of IS-OCT to detect early signs of malignancy.
This is a 2020 ARVO Annual Meeting abstract.