title: Primary Acquired Melanosis: Clinical, Histopathologic and Optical Coherence Tomographic Correlation.
abstract: OBJECTIVE
  To assess the use of anterior segment optical coherence tomography (OCT) as an adjuvant diagnostic tool in primary acquired melanosis (PAM) by correlating clinical, histopathologic and anterior segment OCT findings.
  
  
  METHODS
  Twenty-four patients (24 eyes) with PAM of the conjunctiva, cornea or both were imaged with an anterior segment OCT device (RTVue, model-RT100; Optovue Inc., Fremont, Calif., USA).
  
  
  RESULTS
  Histopathologic diagnosis following excisional or incisional biopsy was confirmed in 13 out of 24 patients (54.6%). OCT images showed a characteristic uniformly thick basal epithelial hyperreflective band (about 20 μm thick) and normal thickness of the overlying epithelial layer in all patients (100%). The hyperreflective band on OCT correlated with the basal epithelial melanocytic pigmentation noted on histopathologic examination but did not vary in thickness between cases with or without atypia.
  
  
  CONCLUSIONS
  The characteristic basal epithelial hyperreflective band with normal overlying epithelium in the absence of cysts observed in all cases by anterior segment OCT correlated with clinical and histopathologic features of conjunctival and corneal PAM. Anterior segment OCT may be helpful as a noninvasive diagnostic tool for PAM. Improvement in resolution is necessary to detect melanocytic hyperplasia and aytpia suggestive of malignant potential.
authors.affiliation: Department of Ophthalmic Oncology, Cole Eye Institute, Cleveland, Ohio, USA.
authors.forename: Yahya A
authors.initials: YA
authors.lastname: Alzahrani
authors.affiliation: Department of Ophthalmic Oncology, Cole Eye Institute, Cleveland, Ohio, USA.
authors.forename: Smita
authors.initials: S
authors.lastname: Kumar
authors.affiliation: Department of Ophthalmic Oncology, Cole Eye Institute, Cleveland, Ohio, USA.
authors.forename: Hassan
authors.initials: H
authors.lastname: Abdul Aziz
authors.affiliation: Anatomic Pathology, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Plesec
authors.affiliation: Department of Ophthalmic Oncology, Cole Eye Institute, Cleveland, Ohio, USA.
authors.forename: Arun D
authors.initials: AD
authors.lastname: Singh
keywords: Corneal epithelium; Correlative microscopy; Immobilization stress; Melanoma; Noninvasive diagnostic tool; Optical coherence tomography