Ocular Surface Squamous Neoplasia (OSSN): A Retrospective Study

Abstract

Background: Ocular surface squamous neoplasia (OSSN) is a term used to describe neoplastic epithelial abnormalities of conjunctiva and cornea, ranging from Squamous Dysplasia to Invasive Squamous Cell Carcinoma. In recent times, the incidence of OSSN seems to be on the rise, especially in developing countries like India.

Aim: To analyse demographic characteristics and compare the clinical presentation, treatment outcomes, and histopathology features of Ocular Surface Squamous Neoplasia (OSSN).

Design: Retrospective cross-sectional study.

Materials and methods: We analysed 113 cases of OSSN who presented to the out-patient department of Sarojini Devi Eye Hospital, Regional Institute of Ophthalmology over a period of three years from February 2012 to January 2015.

Results: In patients, who presented with OSSN age ranged from 18 to 78 years, mean age being 45.20 years. Males were predominantly affected accounting for 65.48%. A nodule at the limbus is the commonest presentation. About 23% of the patients tested positive for HIV in whom mean age of presentation was 34 years. Among HIV positive patients 78.26% had SCC.

Conclusion: Increased incidence of OSSN was observed in males and people with outdoor occupations. Nodular type of lesion is the commonest variety. HIV positive individuals have an increased incidence of OSSN with invasive characteristics. Hence, ophthalmologists need to be aware of this association and a thorough workup is warranted for all patients presenting with OSSN, especially in the younger age group. Our study Also suggests that OSSN may be the first manifestation of underlying HIV infection.

Keywords: Carcinoma in-situ(CIS); Conjunctival neoplasms; Human immunodeficiency virus (HIV) manifestations; Mitomycin-C(MMC); Squamous cell carcinoma (SCC).

[Table/Fig-1]:

Age distribution of patients AGE RANGE of patients in this study= 18–78 Years Mean age = 45.20 Years

[Table/Fig-3]:

Association of HIV

[Table/Fig-4]:

OSSN in hiv positive patient

[Table/Fig-5]:

Distribution of clinical types

[Table/Fig-6]:

Location of lesion

[Table/Fig-7]:

OSSN on nasal side

[Table/Fig-8]:

Distribution of histopathological grades

[Table/Fig-9]:

Distribution of various grades of SCC

[Table/Fig-10]:

Carcinoma in-situ (CIS)

[Table/Fig-11]:

Well differentiated SCC