DEMOGRAPHIC CLINICAL PRESENTATION AND TREATMENT OUTCOME OF OCULAR SURFACE SQUAMOUS NEOPLASIA

Abstract

Purpose: The aim of the study is to analyze demographic, clinical profile and treatment outcome of ocular surface squamous neoplasia (OSSN). Methods: It was a retrospective study and analysis of 36 eyes (36 cases) diagnosed with OSSN, treated at teritiary eye care center over 3 years. Results: The median age of the treated patients was 53 years, patients with outdoor activity were 77.7% (28/36), while human immunodeficiency virus infection (2/36) with predisposing conditions had a younger median age of (32 years). Carcinoma insitu was found in half of the patients n=18 (50%) and treatment advised was wide local excision (4 mm margin clearance) with cryotherapy followed by topical treatment with mitomycin-c 0.04% . Overall, complete regression was achieved in all cases during a mean follow-up of 16.8 ± 3.65 months. No recurrence was seen. Conclusion: Although OSSN is associated with old age, earlier onset of OSSN is seen in patients with systemic predisposing conditions. Males and females are equally prone to OSSN. Most of the patients with OSSN belong to 41-60 years age group. In HIV positive patients, OSSN appeared at an early age and was more aggressive in nature. Nasal quadrant was most commonly involved and the tumor epicenter was limbus. Most common symptom was mass or growth followed by redness and diminution of vision. Sunlight exposure is a major risk factor. Carcinoma insitu was most common histopathological diagnosis followed by Dysplasia and Squamous cell carcinoma. Surgical excision and cryotherapy followed by topical Mitomycin-C weekly on and off for 3-4cycles is associated with best control of primary OSSN with no tumor recurrence.