TY - JOUR
T1 - Use of High-Resolution Optical Coherence Tomography in the Surgical Management of Ocular Surface Squamous Neoplasia
T2 - A Pilot Study
AU - Karp, Carol L.
AU - Mercado, Carolina
AU - Venkateswaran, Nandini
AU - Ruggeri, Marco
AU - Galor, Anat
AU - Garcia, Armando
AU - Sivaraman, Kavitha R.
AU - Fernandez, Maria Paula
AU - Bermudez, Antonio
AU - Dubovy, Sander R.
N1 - Funding Information:
Financial Support: NIH Center Core Grant P30EY014801 , RPB Unrestricted Award and Career Development Awards, Department of Veterans Affairs , Veterans Health Administration, Office of Research and Development , Clinical Sciences Research EPID-006-15S (Dr. Galor), R01EY026174 (Dr.Galor), The Dr. Ronald and Alicia Lepke Grant, The Lee and Claire Hager Grant, The H. Scott Huizenga Grant, The Grant and Diana Stanton-Thornbrough , The Robert Baer Family Grant, The Emilyn Page and Mark Feldberg Grant, The Jose Ferreira de Melo Grant, Richard and Kathy Lesser Grant, The Michele and Ted Kaplan Grant and the Richard Azar Family Grant (institutional grants). Financial Disclosures: The following authors have no financial disclosures: Carol L. Karp, Carolina Mercado, Nandini Venkateswaran, Marco Ruggeri, Anat Galor, Armando Garcia, Kavitha R. Sivaraman, Maria Paula Fernandez, Antonio Bermudez, and Sander R. Dubovy. All authors attest that they meet the current ICMJE criteria for authorship.
PY - 2019/10
Y1 - 2019/10
N2 - Purpose: To evaluate whether high-resolution optical coherence tomography (HR-OCT) can detect histologic tumor margins of ocular surface squamous neoplasia (OSSN). Methods: Eight eyes of 8 patients with OSSN undergoing excision were studied prospectively. Immediately before surgery, the tumor was imaged using commercially available HR-OCT to identify the conjunctival margins of the neoplastic lesion. The tumor borders of the lesion determined by HR-OCT were mapped in relation to an anatomic reference point and transferred intraoperatively. The tumor was excised with 4-mm margins from the visible edge of the lesion with a “no-touch” technique. The specimens were sent for pathologic analysis and the histologic tumor margin was compared to the HR-OCT predicted tumor border. Results: Mean age of the 8 patients was 67 ± 9.9 years. Seven were male, 7 were white, and, ethnically, 3 were Hispanic. All 8 tumors were bulbar and in the exposure zone. Seven tumors were limbal. Corneal extension was present in 5. Mean tumor area was 17.5 ± 11.1 mm2. Clinically, 2 of the tumors were leukoplakic, 1 papillomatous, and 3 gelatinous. A conjunctival tumor margin identified with the HR-OCT coincided with the pathologically confirmed margin mark in all eyes. Conclusions: HR-OCT has the potential to predict histologic tumor margins in OSSN. Optical identification of tumor margins could potentially decrease the incidence of residual positive margins and minimize healthy tissue removal. Advances in HR-OCT technology and integration into a microscope for “real-time” imaging are needed to further improve this technique.
AB - Purpose: To evaluate whether high-resolution optical coherence tomography (HR-OCT) can detect histologic tumor margins of ocular surface squamous neoplasia (OSSN). Methods: Eight eyes of 8 patients with OSSN undergoing excision were studied prospectively. Immediately before surgery, the tumor was imaged using commercially available HR-OCT to identify the conjunctival margins of the neoplastic lesion. The tumor borders of the lesion determined by HR-OCT were mapped in relation to an anatomic reference point and transferred intraoperatively. The tumor was excised with 4-mm margins from the visible edge of the lesion with a “no-touch” technique. The specimens were sent for pathologic analysis and the histologic tumor margin was compared to the HR-OCT predicted tumor border. Results: Mean age of the 8 patients was 67 ± 9.9 years. Seven were male, 7 were white, and, ethnically, 3 were Hispanic. All 8 tumors were bulbar and in the exposure zone. Seven tumors were limbal. Corneal extension was present in 5. Mean tumor area was 17.5 ± 11.1 mm2. Clinically, 2 of the tumors were leukoplakic, 1 papillomatous, and 3 gelatinous. A conjunctival tumor margin identified with the HR-OCT coincided with the pathologically confirmed margin mark in all eyes. Conclusions: HR-OCT has the potential to predict histologic tumor margins in OSSN. Optical identification of tumor margins could potentially decrease the incidence of residual positive margins and minimize healthy tissue removal. Advances in HR-OCT technology and integration into a microscope for “real-time” imaging are needed to further improve this technique.
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U2 - 10.1016/j.ajo.2019.05.017
DO - 10.1016/j.ajo.2019.05.017
M3 - Article
C2 - 31163136
AN - SCOPUS:85068589150
VL - 206
SP - 17
EP - 31
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
SN - 0002-9394
ER -