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Ocular surface squamous neoplasia with 360° limbal involvement: a study of 130 patients

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Abstract

Purpose

To describe the risk factors, clinical features and management outcomes of ocular surface squamous neoplasia (OSSN) with 360° of limbal involvement (360-OSSN) and compare with segmental limbal involvement (SL-OSSN).

Methods

Retrospective comparative study of 360-OSSN vs SL-OSSN. All 360-OSSN and every 10th patient with SL-OSSN during the study period (2012–2020) were included. Lesions with uncertain diagnosis were excluded.

Results

Of 1250 patients diagnosed with OSSN during the study period, 30 (2%) had 360-OSSN. A total of 100 patients of OSSN with SL-OSSN were included for comparison. 360-OSSN patients more often had longer duration of symptoms (mean, 17 vs 8 months; p, 0.003), prior misdiagnosis (17% vs 6%, p, 0.13) and prior intervention (47% vs 13%; p, 0.0002) than patients with SL-OSSN. 360-OSSN had higher incidence of scleral fixity (57% vs 16%; p < 0.0001), corneal/scleral melt (17% vs 0%; p, 0.0005), intraocular tumor extension (17% vs 0%; p, 0.003), orbital tumor extension (33% vs 1%; p < 0.0001), and advanced T stage at presentation (Tis: 37% vs 76%, T1: 0% vs 15%; T2: 7% vs 4%; T3: 27% vs 4%; T4: 30% vs 1%; p < 0.001). Over a mean follow-up of 14 months, lymph node metastasis (8% vs 0%; p, 0.05) and distant metastasis (4% vs 0%; p, 0.23) were more common in 360-OSSN group compared to SL-OSSN group.

Conclusion

Risk factors of 360-OSSN include prolonged symptoms, prior misdiagnosis and prior intervention. It represents an advanced form of disease with propensity for corneo-scleral melt and invasive disease which requires aggressive management.

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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 the preparation, review or approval of the manuscript.

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Authors and Affiliations

  1. Operation Eyesight Universal Institute for Eye Cancer, LV Prasad Eye Institute, Hyderabad, 500034, India

    Vijitha S. Vempuluru, Neha Ghose, Monalisha Pattnaik & Swathi Kaliki

  2. Ophthalmic Biophysics Laboratory, LV Prasad Eye Institute, Hyderabad, India

    Ashik Mohamed

Authors
  1. Vijitha S. Vempuluru
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  2. Neha Ghose
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  3. Monalisha Pattnaik
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  4. Ashik Mohamed
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  5. Swathi Kaliki
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Contributions

SK contributed to the study conception and design. Material preparation, data collection and analysis were performed by VSV, NG, MP, and AM. The first draft of the manuscript was written by VSV and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Swathi Kaliki.

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Competing interests

The authors declare no competing interests.

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of LV Prasad Eye Institute.

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Consent to publish

The authors affirm that human research participants provided informed consent for publication of the images in Figs. 1, 2, and 3

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Vempuluru, V.S., Ghose, N., Pattnaik, M. et al. Ocular surface squamous neoplasia with 360° limbal involvement: a study of 130 patients. Int Ophthalmol 43, 609–618 (2023). https://doi.org/10.1007/s10792-022-02463-7

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  • DOI: https://doi.org/10.1007/s10792-022-02463-7

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