Modern Management of Ocular Surface Squamous Neoplasia
Modern Management of Ocular Surface Squamous Neoplasia
OSSN includes a spectrum of corneal and conjunctival lesions from dysplasia and carcinoma in situ, typically termed conjunctival or corneal intraepithelial neoplasia, to squamous cell carcinoma characterized by epithelial cell invasion into the underlying stroma. OSSN normally occurs in the interpalpebral region arising from the limbal stem cells, involving the bulbar conjunctiva, the cornea or both of these structures. The tarsal conjunctiva is less frequently involved. The lesions appear macroscopically as gelatinous (Figure 1), leukoplakic, papilliform (Figure 2), nodular or diffuse, and may be flat or elevated. A feeder vessel is sometimes present (Figure 1). Symptomatically, OSSN may be associated with mild discomfort, irritation or rarely severe pain.
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Figure 1.
Ocular surface squamous neoplasia with gelatinous and papilliform features and with focal areas of leukoplakia (arrow).
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Figure 2.
Elevated papillary ocular surface squamous neoplasia with feeder vessels (arrows).
Description
OSSN includes a spectrum of corneal and conjunctival lesions from dysplasia and carcinoma in situ, typically termed conjunctival or corneal intraepithelial neoplasia, to squamous cell carcinoma characterized by epithelial cell invasion into the underlying stroma. OSSN normally occurs in the interpalpebral region arising from the limbal stem cells, involving the bulbar conjunctiva, the cornea or both of these structures. The tarsal conjunctiva is less frequently involved. The lesions appear macroscopically as gelatinous (Figure 1), leukoplakic, papilliform (Figure 2), nodular or diffuse, and may be flat or elevated. A feeder vessel is sometimes present (Figure 1). Symptomatically, OSSN may be associated with mild discomfort, irritation or rarely severe pain.
(Enlarge Image)
Figure 1.
Ocular surface squamous neoplasia with gelatinous and papilliform features and with focal areas of leukoplakia (arrow).
(Enlarge Image)
Figure 2.
Elevated papillary ocular surface squamous neoplasia with feeder vessels (arrows).