title: Role of high resolution optical coherence tomography in diagnosing ocular surface squamous neoplasia with coexisting ocular surface diseases.
abstract: Coexistence of an ocular surface disease can mask the typical features of ocular surface squamous neoplasia (OSSN). The purpose of this study was to evaluate high resolution optical coherence tomography (HR-OCT) as an adjunct in the detection and differentiation of OSSN within coexisting ocular surface pathologies.
  
  
  
  Retrospective study of 16 patients with ocular surface disease and lesions suspicious for OSSN that were evaluated with HR-OCT. HR-OCT images of the lesions were taken to look for evidence of OSSN. Biopsies were performed in all cases, and the HR-OCT findings were compared to the histological results.
  
  
  
  Of the 16 patients with OSSN and a coexisting ocular surface disease, 12 were found to have OSSN by HR-OCT and all were subsequently confirmed by biopsy. Two patients had OSSN with rosacea, one with pingueculum, two within pterygia, one with Salzmann' nodular degeneration, six with limbal stem cell deficiency (LSCD)/scarring. In all 12 cases HR-OCT images revealed classical findings of hyper-reflective, thickened epithelium and an abrupt transition from normal to abnormal epithelium. OSSN was ruled out by HR-OCT in four cases (2 Salzmann's, 1 mucous membrane pemphigoid, and 1 LSCD). Negative findings were confirmed by biopsy. HR-OCT was used to follow resolution of the OSSN in positive cases, and it detected recurrence in 1 case.
  
  
  
  While histopathology is the gold standard in the diagnosis of OSSN, HR-OCT can be used to noninvasively detect the presence of OSSN in patients with coexisting ocular conditions.
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Marwan
authors.initials: M
authors.lastname: Atallah
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Madhura
authors.initials: M
authors.lastname: Joag
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Anat
authors.initials: A
authors.lastname: Galor
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Amescua
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Afshan
authors.initials: A
authors.lastname: Nanji
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Jianhua
authors.initials: J
authors.lastname: Wang
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Victor L
authors.initials: VL
authors.lastname: Perez
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Sander
authors.initials: S
authors.lastname: Dubovy
authors.affiliation: Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA. Electronic address: ckarp@med.miami.edu.
authors.forename: Carol L
authors.initials: CL
authors.lastname: Karp
mesh_terms: D002294:Carcinoma, Squamous Cell; D005128:Eye Diseases; D005134:Eye Neoplasms; D006801:Humans; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence
keywords: Conjunctiva; Cornea; Lymphoma; Melanoma; Ocular surface squamous neoplasia (OSSN); Optical coherence tomography (OCT); Pterygium; Tumor