Affiliation:
1. Surgical and Research Services, Miami Veterans Administration Medical Center, Miami, FL;
2. Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL; and
3. LV Prasad Eye Institute, Cornea and Anterior Segment Services, Hyderabad, India.
Abstract
Purpose:
The aim of this study was to compare clinical characteristics and high-resolution optical coherence tomography (HR-OCT) findings between corneal ocular surface squamous neoplasia (OSSN) and corneal pannus.
Methods:
Retrospective study of 9 individuals, 3 with lesions histologically confirmed to be OSSN, 3 with lesions histologically confirmed to be pannus, 1 with lesions histologically confirmed to be OSSN followed by pannus, and 2 with long-standing, nonchanging lesions clinically diagnosed as pannus. All individuals presented to the Miami Veterans Affairs Medical Center eye clinic or Bascom Palmer Eye Institute between 2015 and 2023. Clinical characteristics and HR-OCT findings were evaluated and compared.
Results:
Mean age of the population was 72.8 ± 5.1 years, 100% self-identified as male, 100% as White, and 11.1% as Hispanic. Clinically, all lesions appeared as whitish, opalescent, variably vascularized opacities extending from the limbus. None of the OSSN cases had vessels that extended to the border, whereas 4 cases of pannus (67%) had at least 1 vessel that reached the border. On HR-OCT, epithelial hyperreflectivity was observed in all cases of OSSN and pannus. Epithelial thickening was observed in all cases of OSSN, but in none of the cases of pannus. An important distinction between the 2 groups was the transition between normal and abnormal epithelium. All cases of OSSN had a vertical transition, whereas all cases of pannus had an angled transition.
Conclusions:
Corneal OSSN and corneal pannus can both present with clinical findings of an opalescent lesion and may have overlapping findings on HR-OCT. Although both entities may show epithelial hyperreflectivity on HR-OCT, OSSN demonstrates an abrupt transition at a vertical, 90 degrees angle perpendicular to the Bowman layer, whereas pannus appears as an angled transition around 45 degrees. Therefore, the angle of transition between normal and abnormal epithelium can be useful in distinguishing between the 2 entities.
Funder
Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Clinical Sciences R&D
Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Biomedical Laboratory R&D (BLRD) Service
Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Rehabilitation R&D
Department of Defense Gulf War Illness Research Program
Department of Defense Vision Research Program
National Eye Institute
NIH Center Core Grant
Research to Prevent Blindness
Dr. Ronald and Alicia Lepke Grant
The Lee and Claire Hager Grant
The Grant and Diana Stanton-Thornbrough
The Robert Baer Family Grant
The Emilyn Page and Mark Feldberg Grant
The Robert Farr Family Grant
The Jose Ferreira de Melo Grant
Mr. and Mrs. Irwin Friedman Grant
The Roberto and Antonia Menendez Family Grant
The Stephen Takach Grant
The Richard and Kathy Lesser Grant
The Ragheb Family Grant
The Honorable A. Jay Cristol Grant
The Michele and Ted Kaplan Grant
The Christian Kathke Grant
The Carol Soffer Grant
The Richard Azar Family Grant
Publisher
Ovid Technologies (Wolters Kluwer Health)