Clinico-Demographic Profile of patients with Ocular Surface Squamous Neoplasia in tertiary care Hospital of North India

Abstract

Background: Ocular surface squamous neoplasia (OSSN) is a term used to describe neoplastic epithelial abnormalities of conjunctiva and cornea, ranging from Squamous Dysplasia to Invasive Squamous Cell Carcinoma. In current times, the incidence of OSSN seems to be on the rise, particularly in developing countries like India. Aim: To study demographic characteristics and compare the clinical presentation and histopathology features of Ocular Surface Squamous Neoplasia (OSSN) in a tertiary eye care hospital. Design: Retrospective cross-sectional study. Methods: We study 47 cases of OSSN who presented to the out-patient department of Ophthalmology over a period of 18 months were retrospectively studied for clinical, demographic profiles and histopathological features. Results: A total of 47 patients were incorporated in this study. The average age of patients was 44.56 years (range- 15 years to 84 years) consisting of 23(57.5%) male and 17 (42.5%) female. The ratio of participating male and female patients (M:F) was 1.35:1. Nasal bulbar conjunctiva in (72.5%) was the most frequently involved. A nodule at the limbus is the commonest presentation. Nodular type of lesions seen in 24 patients (60%) followed by leukoplakic seen in 22.5% patients . Diffuse type seen in 17.5% patients. Total 22.5 % of patients having OSSN were found to be HIV positive. Histologically, invasive lesions seen in 14 patients (35%), Carcinoma in-situ in 15 (37.5%) and Mild to severe dysplasia in 11(27.5%) Conclusion: Increased incidence of OSSN was seen in males and people with outdoor occupations. Nodular type of lesion is the commonest variety. HIV positive individuals have an increased incidence of OSSN with invasive characteristics. Hence, ophthalmologists need to be alert of this association and a meticulous workup is warranted for all patients presenting with OSSN, particularly in younger age group. Our study also suggests that OSSN may be one of the manifestation of underlying HIV infection.