Ocular Surface Squamous Neoplasia with Coexistent Pterygia: A Study of 14 Cases and Review of Literature

ABSTRACT

Purpose

To report the clinical presentation, anterior segment optical coherence tomography features, treatment, and outcomes of ocular surface squamous neoplasia (OSSN) associated with pterygium.

Methods

Retrospective interventional series of 14 cases in a 28-month study period.

Results

OSSN was coexistent with pterygium (n = 14) in < 1% of all pterygia (n = 7384). The mean age at the presentation of OSSN with pterygium was 49 years (median, 49 years; range, 36 to 71 years). Referral diagnosis included pterygium sans OSSN (n = 7, 50%), granuloma (n = 1, 7%), actinic keratosis (n = 1, 7%), and conjunctivitis (n = 1, 7%). All OSSNs were unilateral, and six patients (43%) had bilateral pterygia. Tumors arose from the nasal (n = 8, 57%), or temporal (n = 6, 43%) quadrants. The mean tumor diameter was 4 mm (median, 4 mm; range, 2 to 6 mm), and the mean thickness was 2 mm (median, 1 mm; range, 1 to 3 mm). The delineation between OSSN and pterygium could be identified on anterior segment optical coherence tomography (AS-OCT) in all (100%) cases. All patients received 1% topical 5-fluorouracil (5-FU), and complete tumor regression was achieved in 13 (93%) cases with a mean number of 2 cycles (median, two cycles; range, 1 to 4 cycles). There were no significant adverse effects. No tumor recurrence was noted over a mean follow-up period of 11 months (median 12 months; range, 1 to 4 months)

Conclusion

AS-OCT allows accurate detection and mapping of tumor extent in OSSN with coexistent pterygium, and topical 5-FU yields excellent tumor control.

KEYWORDS:

• 5-fluorouracil
• anterior segment optical coherence tomography
• CIN
• Eye
• OSSN
• pterygium
• SCC
• Tumor

DISCLOSURE STATEMENT

No potential conflict of interest was reported by the author(s).

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/08820538.2024.2346748

Additional information

Funding

Support provided by The Operation Eyesight Universal Institute for Eye Cancer (SK) and Hyderabad Eye Research Foundation (SK), Hyderabad, India. The funders had no role in preparing, reviewing, or approving the manuscript.