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Comparative evaluation of clinical characteristics of biopsy-proven conjunctival intraepithelial neoplasia and invasive squamous cell carcinoma using image processing software programs

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Abstract

Purpose

To identify morphological parameters aiding clinical differentiation of conjunctival intraepithelial neoplasia (CIN) and invasive squamous cell carcinoma (iSCC) and to demonstrate the utility of image processing software to objectively assess ocular surface squamous neoplasia (OSSN).

Methods

This retrospective case series included all biopsy-proven cases of OSSN presenting as an ocular surface nodule. Based on histopathology, lesions were classified as CIN and iSCC. Clinical image analysis utilized ‘Contour’ and ‘ImageJ’ software. The effect of predictors demography, seropositivity, lesion dimensions, keratin, pigmentation, corneal involvement, vascularity and feeder vessels on the final histopathologic grade were assessed.

Results

A total of 108 OSSN lesions (74 CIN and 33 iSCC) were included. Mean age was 46.1 ± 17.2 years in CIN and 47.2 ± 13.9 years in iSCC. By univariate logistic regression analysis, significant predictors of iSCC were HIV seropositivity (p < 0.0001), maximum diameter (p = 0.003), perpendicular to maximum diameter (p = 0.003), height (p = 0.003), nodular morphology (p = 0.006) and feeder vessels (p = 0.03), whereas gelatinous morphology (p = 0.02) was predictor of CIN. By multiple logistic regression, seropositivity was the predictor of iSCC (p < 0.0001, OR 13.33 ± 8.35, 95% CI 3.90–45.53).

Conclusion

HIV seropositivity is an important predictor of iSCC. Large, thick, nodular lesions with feeder vessels may favor the diagnosis of iSCC, whereas gelatinous, small, flatter lesions without feeder vessels may favor CIN. In a first of its kind study, simple and objective analysis of OSSN with image processing software was demonstrated.

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Funding

Supported by Hyderabad Eye Research Foundation, Hyderabad, India; and the Operation Eyesight Universal Institute for Eye Cancer, Hyderabad, India.

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Authors and Affiliations

  1. The Operation Eyesight Universal Institute for Eye Cancer, L V Prasad Eye Institute, Vijayawada, Krishna, 521137, India

    Vijitha S. Vempuluru & Anasua Ganguly Kapoor

  2. The Operation Eyesight Universal Institute for Eye Cancer, L V Prasad Eye Institute, Hyderabad, India

    Swathi Kaliki & Sai Divya Jajapuram

  3. Ophthalmic Biophysics, L V Prasad Eye Institute, Hyderabad, India

    Ashik Mohamed

  4. Ophthalmic Pathology Laboratory, L V Prasad Eye Institute, Hyderabad, India

    Dilip K. Mishra

Authors
  1. Vijitha S. Vempuluru
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  2. Anasua Ganguly Kapoor
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  3. Swathi Kaliki
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  4. Sai Divya Jajapuram
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  5. Ashik Mohamed
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  6. Dilip K. Mishra
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Contributions

VSV was responsible for data collection, image analysis and drafting the manuscript; AGK was responsible for the core concept, patient care and editing the manuscript; SK was responsible for patient care and editing the manuscript; SDJ was responsible for data collection; AM was responsible for data analysis and editing the manuscript; DKM was responsible for patient care, image acquisition and editing the manuscript.

Corresponding author

Correspondence to Anasua Ganguly Kapoor.

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The authors declare that they have no conflict of interest.

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Approval for this study has been obtained from Institute Ethics Committee.

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Vempuluru, V.S., Kapoor, A.G., Kaliki, S. et al. Comparative evaluation of clinical characteristics of biopsy-proven conjunctival intraepithelial neoplasia and invasive squamous cell carcinoma using image processing software programs. Int Ophthalmol 41, 1301–1307 (2021). https://doi.org/10.1007/s10792-020-01687-9

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  • DOI: https://doi.org/10.1007/s10792-020-01687-9

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