Ocular surface squamous neoplasia eye ppt

Ocular surface squamous neoplasia
In eye

1. Ocular Surface Squamous Neoplasia (OSSN) Clinical Overview and Case Scenarios Eye Conference Presentation

2. Overview of OSSN Spectrum of conjunctival and corneal epithelial neoplasia Ranges from dysplasia to invasive carcinoma

3. Epidemiology Incidence higher in tropical regions Associated with UV exposure and immunosuppression

4. Risk Factors UV-B radiation HPV infection HIV/AIDS Chronic irritation, exposure to dust or chemicals

5. Pathogenesis Dysplastic changes in limbal stem cells Mutations in p53 and loss of heterozygosity

6. Clinical Spectrum Conjunctival intraepithelial neoplasia (CIN) Carcinoma in situ Invasive squamous cell carcinoma

7. Diagnosis Slit-lamp findings: gelatinous, papilliform, leukoplakic lesion AS-OCT shows epithelial thickening and hyper-reflectivity

8. Histopathology Dysplasia limited to epithelium in CIN Stromal invasion in SCC Positive immunostaining for cytokeratin

9. Differential Diagnosis Pterygium Pinguecula Limbal dermoid Papilloma

10. Case 1: Limbal OSSN – Presentation 45-year-old male, chronic sun exposure Limbal gelatinous mass with feeder vessels

11. Case 1: Management & Outcome No-touch excision with cryotherapy Topical IFN-α2b post-op No recurrence at 12 months

12. Case 2: Diffuse/Recurrent OSSN – Presentation 60-year-old female, prior MMC therapy Diffuse conjunctival thickening

13. Case 2: Treatment & Follow-up Topical IFN-α2b and 5-FU combination Partial regression at 6 months Stable at 1-year follow-up

14. Medical Management Topical agents: IFN-α2b, 5-FU, Mitomycin-C Used for primary or adjuvant therapy

15. Surgical Management No-touch technique Alcohol epitheliectomy Cryotherapy at margins

16. Recent Advances AS-OCT for margin assessment Topical immunotherapy as first-line in selected cases

17. Prognosis Recurrence 5–15% with adequate margins Prognosis excellent if early diagnosed

18. Summary OSSN is a treatable ocular surface malignancy Early recognition and multimodal therapy improve outcomes

19. References Shields CL et al. Ophthalmology. 2024. Karp CL et al. Cornea. 2023. American Academy of Ophthalmology Updates 2025.