P-180

OCULAR SURFACE DISORDERS

PRESENTING AUTHOR: DR.SRIVIDYA

CHIEF AUTHOR: DR.KAVITA SALAGAR
(KOS-NO:1422).
CO-AUTHOR: DR.VISHWANATH REDDY.
DR.VEERESH KORWAR.
DR.VINEETH BHIMSHETTY.

M R MEDICAL COLLEGE,KALABURGI

AUTHOR HAS NO FINANCIAL INTEREST

INTRODUCTION
 OCULAR SURFACE SQUAMOUS NEOPLASIA is a
uncommon tumor.

 LEE and HERST describes spectrum of conjunctival, corneal

intraepithelial Neoplasia .

 Manifest as Dysplasia, CIN and invasive squamous cell carcinoma.

 Risk factors include a history of intense sunlight exposure, male sex,

outdoor occupations, advanced age, smoking, light complexion, AIDS,
Xeroderma pigmenntosa, HPV 6,11,16, 18

 The pathogenesis of tumors appears to be disordered epithelial

maturation induced by various irritants.
 People with AIDS tends to
develop conjunctival and
corneal SSC at a young
age and aggressive than the
typical conjunctiva scc.

No of OSSN Templeton
cases found an
relative to total average
No of orbital
tumor ranges
OSSN incidence of
0.13/1 lakh
from 4% to population,
29%.

Primarily occurs in older

males with incidence of
1.9/1 lakh
32 year male presented with complaints of Mass in left eye since 8
months
Mass was Insidious in onset,gradually progressive

Dimension of vision in left eye since 3 months insidious in onset

gradually progressive .
No History of Trauma

Patient was diagnosed to be HIV positive 1 year back

On regular ART treatment (Zidovudine-Lamivudine-Nevirapine

OD OS
VA 20/20 20/30

With 20/20 20/20

pinhole
Near Vision N6 N6
 LEFT EYE

• Placoid lesion with shiny velvetty

•Encroaching 2mm on cornea with
elevated surface at interpalpebral
Tufted Feeder vessels and surface
fissure conjunctiva straddling the
keratin inferiorly.
limbus

Rest all anterior segment was normal

 Total mass excision done
Excisional biopsy sent for HPR.

Topical chemotherapy using

CRYOTHERAPHY mitomycin C (0.02%) drops
[Freeze-thaw technique] administered 4 times daily
for 1 to 2 weeks
 HISTOPATHOLOGY GOLD STANDARD
TECHNIQUE

• Report revealed Hyperplastic,

Acanthotic Stratified
Squamous Epithelium(SSE)

•Dysplastic changes and

subepithelial infilterate.

• Tumor Cells were

arranged in a nest and
scattered singly.
No symblepharon, restricted ocular
motility, or scleral melting was seen
following Cryotherapy.

Patient was followed up regularly.

No recurrent intraepithelial neoplasia

even upto 9 months following the
excision.

No metastasis noted.
 CONCLUSION
• Unilateral gelatinous papilliform squamous cell carcinoma in
patients with concurrent AIDS are rare, particularly likely to
exhibit rapidly progressive malignant conjunctival and corneal
neoplasms of the SSE and metastasis of those neoplasms.

• Role of complete surgical excision + cryotherapy +

mitomycin therapy

• It has favourable outcome with prevention of recurrence.

 REFERENCES
 British Journal of Ophthalmology 2012:84: Page
268-272.
 Delhi Journal of Ophthalmology 2012;23(2):89-96.
 Albert and Jakobiec, Principles and Practice of
Ophthalmology, 3rd Edition, Vol-3, Page 3584-3586.
 American Academy of Ophthalmology 2015 Edition,
Page 2001.
 Yanoff and Duker, Ophthalmology, 4th Edition,
Page 196-198.

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