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• W3014082913 abstract "INTRODUCTION:The term Ocular Surface Squamous Neoplasia was coined by Lee and Hirst. It includes a spectrum of conjunctival and corneal epithelial neoplasia manifesting as dysplasia, carcinomain-situ and invasive squamous cell carcinoma. Incidence of OSSN has a wide geographical variation, ranging from 0.13 to 1.9 per 100,000 population. It is more common in males. The average age of presentation is usually in the sixth and seventh decades. The exact pathogenesis of OSSN is unknown but is probably multifactorial. Risk factors include exposure to ultraviolet B radiation, HPV infection (6&11), HIV infection etc. These tumors commonly occur at the limbus and usually unilateral.Morphological Classification:1. Gelatinous- Circumscribed gelatinous lesions are the most common. The nodular type is rapidly growing with a high incidence of metastasis to adjacent lymph nodes.2. Leukoplakic- These are usually pre invasive.3. Papilliform- These are typically are exophytic, strawberry like, with a stippled red appearancecorresponding to its fibro vascular core. They are clinically benign. Corneal papilliform OSSN lesions are pre invasive, with a mottled ground glass sheet appearance which is opalescent. They have sharply defined fimbriated borders, the convex leading edge spreads in an arc away from the limbus and often white dots are present over the grey epithelium.These lesions are typically indolent, slow growing and prone to recurrence.Diagnosis : OSSN can be diagnosed by various techniques such as Impression Cytology, Anterior Segment OCT, Confocal Microscopy and Histopathology.Impression cytology: Impression cytology refers to the histological, immunohistological, ormolecular analysis of superficial layers of ocular surface epithelium.Histopathology : Histopathology is the gold standard for the diagnosis and grading of OSSN.Excision biopsy is both diagnostic and curative. Incision biopsy is undertaken only when thetumor is extensive and orbital exenteration has been planned.Aim: To analyse the non invasive techniques in the diagnosis of OSSN.OBJECTIVE: to evaluate the accuracy of impression cytology in the diagnosis of OSSN.MATERIALS AND METHODS:Study Centre: RIOGOH , Chennai.Study design : Prospective study.Inclusion criteria : Patients of age more than 30-70 years with growth over the ocular surface.Exclusion criteria : Patients with pterygium, patients with severe debilitation.Sample size: 50.Methodology: A detailed history and examination of growth by slit lamp was done.Impression cytology was done in all patients prior to excision biopsy.Impression Cytology Technique:A drop of 4% xylocaine was instilled into the eye of the patient. Cellulose acetate filter paper was held with a sterile forceps and pressed firmly against the lesion for about 5 to 10 seconds, then transferred into a container of 95% alcohol for about half an hour for fixation. It was then mounted onto a slide, stained with haematoxylin and eosin and observed under light microscope. The slides were examined and observed for the presence of dysplastic cells, hyperkeratosis, inflammatory cells or any other associated findings. Histopathology: The specimens were obtained from excision biopsies and graded.Grades of OSSN on histopathology:Mild dysplasia: Dysplastic cells restricted to the lower one-third of the epithelial layer.Moderate dysplasia: Dysplastic cells occupying two thirds of the thickness of epithelium.Severe dysplasia / Carcinoma-in-situ: Complete involvement of the epithelium includingsurface layer without breach of the basement membrane.Invasive squamous cell carcinoma: Breach of the basement membrane with involvement ofsubstantia propria by tumor cells .CONCLUSION: 50 excision biopsies were performed for suspected OSSN. There was correlationwith impression cytology in 47 cases [94%]. In 3 cases there were no correlation [6%]. Out ofwhich 2 cases showed dysplastic changes in impression cytologyand HPE showed no dysplasia.The remaining one was normal in impression cytology but HPE showed severe dysplastic changes.Based on this study after calculating epidemiological indices impression cytology can be used a screening tool in diagnosing ossn. But Histopathology always remains the gold standard in diagnosing OSSN." @default.
• W3014082913 created "2020-04-03" @default.
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• W3014082913 date "2017-04-01" @default.
• W3014082913 modified "2023-09-27" @default.
• W3014082913 title "Analytical study on non invasive techniques in diagnosing ocular surface Squamous Neoplasia" @default.
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