Canadian journal of ophthalmology. Journal canadien d'ophtalmologie · 2026
Ocular surface squamous neoplasia: insights from 67 cases at a Quebec tertiary center.
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Tolba Rayan, Lin Grace, Callejo Sonia, Sainani Kanchan, Jabbour Samir, Segal Laura, Racine Louis, Harissi-Dagher Mona, Nguyen Quynh, Massicotte Erika, Daigle Patrick, Robert Marie-Claude
Аннотация
OBJECTIVE: To evaluate the demographics, clinical characteristics, treatments, and outcomes of patients with ocular surface squamous neoplasia (OSSN).
DESIGN: A retrospective cohort study.
PARTICIPANTS: Patients followed for OSSN at the Centre Hospitalier de l'Université de Montréal in Quebec between 2013 and 2024.
METHODS: Baseline characteristics were extracted alongside pathologic grades, treatment modalities, and recurrences.
RESULTS: In total, 67 eyes from 66 patients with a median age at diagnosis of 71 years (range 43-92) were identified. Of the patients, 67.2% (n = 45) were male, and 25.5% (n = 13/51) had a history of skin cancer. Lesions most frequently presented on the bulbar conjunctiva (41%, n = 57), the limbus (25.9%, n = 36), and/or the cornea (13.7%, n = 18). Lesions were papillomatous (31.6%, n = 30), gelatinous (29.5%, n = 28), and leukoplakic (23.2%, n = 22). Of the 80.6% (n = 54) of patients who underwent surgery, 36 received combination therapy with topical drops preoperatively (n = 5), postoperatively (n = 24), or both (n = 7). A total of 19.4% (13) had topical chemotherapy alone: 5-fluorouracil 1% (n = 3), and interferon α2b (n = 10). In cases in which histopathology was available (n = 52), conjunctival intraepithelial neoplasia (CIN) was seen in 87% (n = 45) (CIN1: 4% [n = 2], CIN2: 13% [n = 7], and CIN3: 69% [n = 36]) whereas 13% (n = 7) were squamous cell carcinoma. Recurrence occurred in 23.9% (n = 16). On Cox regression, recurrences were not associated with specific treatment approaches (all hazard ratio CIs crossing 1; P > 0.639) but were associated with positive margins (hazard ratio 3.892; P = 0.04).
CONCLUSIONS: OSSN in Quebec predominantly presents as papillomatous bulbar conjunctival lesions in the older White men. In total, 83% of biopsied lesions are of a higher grade (CIN3 and SCC), warranting efforts for earlier detection and referral.
DESIGN: A retrospective cohort study.
PARTICIPANTS: Patients followed for OSSN at the Centre Hospitalier de l'Université de Montréal in Quebec between 2013 and 2024.
METHODS: Baseline characteristics were extracted alongside pathologic grades, treatment modalities, and recurrences.
RESULTS: In total, 67 eyes from 66 patients with a median age at diagnosis of 71 years (range 43-92) were identified. Of the patients, 67.2% (n = 45) were male, and 25.5% (n = 13/51) had a history of skin cancer. Lesions most frequently presented on the bulbar conjunctiva (41%, n = 57), the limbus (25.9%, n = 36), and/or the cornea (13.7%, n = 18). Lesions were papillomatous (31.6%, n = 30), gelatinous (29.5%, n = 28), and leukoplakic (23.2%, n = 22). Of the 80.6% (n = 54) of patients who underwent surgery, 36 received combination therapy with topical drops preoperatively (n = 5), postoperatively (n = 24), or both (n = 7). A total of 19.4% (13) had topical chemotherapy alone: 5-fluorouracil 1% (n = 3), and interferon α2b (n = 10). In cases in which histopathology was available (n = 52), conjunctival intraepithelial neoplasia (CIN) was seen in 87% (n = 45) (CIN1: 4% [n = 2], CIN2: 13% [n = 7], and CIN3: 69% [n = 36]) whereas 13% (n = 7) were squamous cell carcinoma. Recurrence occurred in 23.9% (n = 16). On Cox regression, recurrences were not associated with specific treatment approaches (all hazard ratio CIs crossing 1; P > 0.639) but were associated with positive margins (hazard ratio 3.892; P = 0.04).
CONCLUSIONS: OSSN in Quebec predominantly presents as papillomatous bulbar conjunctival lesions in the older White men. In total, 83% of biopsied lesions are of a higher grade (CIN3 and SCC), warranting efforts for earlier detection and referral.