title: High-Resolution Optical Coherence Tomography as an Adjunctive Tool in the Diagnosis of Corneal and Conjunctival Pathology.
abstract: OBJECTIVE
  To evaluate the use of a commercially available, high-resolution, spectral-domain optical coherence tomography (HR-OCT) device in the diagnosis of corneal and conjunctival pathologies, with a focus on malignant lesions.
  
  
  METHODS
  Eighty-two eyes of 71 patients were enrolled in this prospective case series, including 10 normal eyes, 21 with ocular surface squamous neoplasia (OSSN), 24 with a pterygium or pingueculum, 3 with lymphoma, 18 with pigmented conjunctival lesions (nevus, flat melanosis, or melanoma), and 6 with Salzmann nodular degeneration. Subjects were imaged using photography and HR-OCT (RTVue, Optovue, Fremont, CA). When clinically indicated, surgery was performed and histopathologic specimens were correlated with OCT images.
  
  
  RESULTS
  HR-OCT was useful in differentiating among various lesions based on optical signs. Specifically, in OSSN, HR-OCT findings included epithelial thickening and hyper-reflectivity, whereas pterygia and pinguecula showed a subepithelial mass under thinner epithelium. In lymphoma, a hypo-reflective, homogenous subepithelial mass was observed. Differentiating between pigmented lesions with HR-OCT was more difficult, but certain characteristics could be identified. Eyes with nevi and melanoma both displayed intensely hyper-reflective basal epithelial layers and discrete subepithelial lesions, but could be differentiated by the presence of cysts in nevi and intense shadowing of sublesional tissue in most melanomas.
  
  
  CONCLUSIONS
  We found that a commercially available HR-OCT was a useful noninvasive adjunctive tool in the diagnosis of ocular surface lesions.
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA.
authors.forename: Afshan A
authors.initials: AA
authors.lastname: Nanji
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA.
authors.forename: Fouad E
authors.initials: FE
authors.lastname: Sayyad
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA; Miami Veteran Affairs Medical Center, Miami, FL, USA.
authors.forename: Anat
authors.initials: A
authors.lastname: Galor
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA; Florida Lions Ocular Pathology Laboratory, Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA.
authors.forename: Sander
authors.initials: S
authors.lastname: Dubovy
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA. Electronic address: ckarp@med.miami.edu.
authors.forename: Carol L
authors.initials: CL
authors.lastname: Karp
mesh_terms: D003228:Conjunctiva / Q000473:pathology*; D003229:Conjunctival Diseases / Q000175:diagnosis*; D003315:Cornea / Q000473:pathology*; D003316:Corneal Diseases / Q000175:diagnosis*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D041623:Tomography, Optical Coherence / Q000379:methods*
keywords: High-resolution optical coherence tomography (OCT); RTVue; lymphoma; melanoma; neoplasia; ocular surface lesions; ocular surface squamous neoplasia; pterygium