Ocular Findings in Women with Cervical HPV Positivity and Cervical Dysplasia Undergoing Loop Electrosurgical Excision Procedure: A Prospective Cross-Sectional Study.

Background and

Objectives

To evaluate ocular findings in women with cervical HPV positivity undergoing loop electrosurgical excision procedure (LEEP) for cervical dysplasia and to assess conjunctival/eyelid papilloma and other ocular findings in this cohort. Materials and

Methods

This single-center, prospective, cross-sectional observational study was conducted at a tertiary referral hospital between September 2021 and October 2023. Women in whom LEEP was planned because of cervical dysplasia were eligible for inclusion. Patients who consented to ophthalmologic evaluation underwent preoperative eye examination and were included in the study. For the final analysis, women with cervical HPV negativity were excluded. Demographic characteristics, cervical HPV status and subtype, colposcopic biopsy histopathology, final LEEP histopathology, and ophthalmologic findings were recorded prospectively. Ocular findings were classified as normal ocular findings, conjunctival/eyelid papilloma, or other ocular findings.

Results

A total of 75 women were included in the final analysis. Normal ocular findings were observed in 66 women (88.0%), conjunctival/eyelid papilloma lesions were identified in 3/75 (4.0%), and other ocular findings were identified in six (8.0%). There were no significant differences among the ocular finding groups in age, gravida, or parity. Alcohol use differed across ocular finding groups (p = 0.039), although this finding was based on only three patients in the papilloma group and should be regarded as exploratory. Ocular findings were associated with colposcopic biopsy histopathology (p = 0.016) but not with final LEEP histopathology. In exploratory adjusted analyses, no independent predictor of conjunctival/eyelid papilloma or any other ocular pathology was identified.

Conclusions

In this cohort, the majority of patients had normal ocular findings, and conjunctival/eyelid papilloma lesions were identified in only three patients. The observed ocular findings did not support a clinically meaningful cervical-ocular association in this cohort. Further studies with ocular tissue-based HPV testing are needed to investigate whether HPV is present in ocular lesions and whether these findings correspond to cervical HPV results.