Characteristics of Conjunctival Myxomas on Anterior Segment Ocular Coherence Tomography

Abstract

Purpose : High-resolution optical coherence tomography (HR-OCT) is a powerful tool that can identify a variety of ocular surface pathologies. In this study, we present the largest retrospective case series in the literature of individuals diagnosed with conjunctival myxoma and with anterior segment HR-OCT.

Methods : This is a retrospective case series of individuals diagnosed with conjunctival myxoma with accompanying review of the literature.

Results : Four individuals presented to a tertiary referral center with pinkish and variably elevated conjunctival lesions. Biopsy confirmed conjunctival myxoma in all cases. All lesions had highly concordant findings on HR-OCT, including a normal epithelium and subepithelial, heterogeneous lesions with hyper- and hypo-reflective areas. The hypodense areas likely correspond to paucicellular, myxoid material. Round and linear hypo-reflective spaces are present which correlate with cross-sectional and longitudinal sections of prominent vasculature in the substancia propria.

Conclusions : Conjunctival myxoma has distinctive features on HR-OCT which can aid the clinician in arriving at a correct diagnosis and guiding therapy.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

 

External photographs of conjunctival myxomas upon presentation in cases 1-4, denoting a pink, subepithelial elevation of the bulbar conjunctiva (panels A-D, respectively).

 

Anterior segment OCT demonstrates subepithelial mass with hyper-reflective and hypo-reflective material, hypo-reflective, cyst-like structures within the subepithelial mass and normal overlying epithelium in cases 1-4 (panels A-D, respectively)