Abstract
This study aims to systematically review the reported literature on the use of anterior segment optical coherence tomography (AS-OCT) in ocular surface tumours and simulating lesions. A systematic literature search was done using PubMed, Scopus, and Web of Science databases between January 2002 and December 2021. On AS-OCT, ocular surface squamous neoplasia typically demonstrate epithelial thickening, epithelial hyperreflectivity, and an abrupt transition between normal and abnormal epithelium. Conjunctival nevi usually show mildly hyperreflective epithelium of normal thickness, internal hyperreflectivity, and intralesional cysts which is the hallmark of this tumour. Primary acquired melanosis presents with normal thickness epithelium, basal epithelial hyperreflectivity, and absence of cysts. Conjunctival melanoma demonstrates hyperreflective normal/thickened epithelium, hyperreflective basal epithelium, internal hyperreflectivity, and absence of intralesional cysts. Conjunctival lymphoma shows homogenous, low-medium reflective subepithelial lesions with smooth borders, and dot-like infiltrates. Benign reactive lymphoid hyperplasia findings are similar to lymphoma but the infiltrates are more hyperreflective compared to lymphoma. Pterygium shows thickened conjunctival epithelium, epithelial hyperreflectivity, and subepithelial wedge-shaped hyperreflective tissue separated from the overlying epithelium by a cleavage plane. Pinguecula demonstrates mildly thickened epithelium and similar findings with pterygium but does not extend beyond the corneal limbus. This review shows that AS-OCT, as a noninvasive tool, has potential uses in the differential diagnosis of ocular surface tumours and simulating lesions. Major limitations of AS-OCT include limited visualization of the posterior border of thick, keratinized, and pigmented tumours and lack of assessment of large conjunctival tumours in a single cut.
摘要
本研究旨在系统性综述已发表的有关前节光学相干断层扫描技术(AS-OCT)用于眼表肿瘤和模拟病变中的文献。我们使用 PubMed、Scopus和Web of Science数据库对发表于2002年1月至2021年12月期间的文献进行了系统检索。眼表鳞状肿瘤在AS-OCT上通常表现为上皮增厚、上皮高反射性, 以及正常和异常上皮之间的突变。结膜痣通常以为厚度正常的上皮轻度高反射灶, 内部高反射性, 以及病灶内囊肿为特征。原发性获得性黑色素瘤表现为上皮厚度正常, 基底上皮高反射性灶及无囊肿。结膜黑色素瘤表现为正常/增厚上皮的高反射, 基底上皮高反射, 内部呈高反射, 无病灶内囊肿。结膜淋巴瘤表现为均匀的、中-低度反射的上皮下病灶, 边界光滑并伴随点状浸润。良性反应性淋巴增生的表现与淋巴瘤相似, 但与淋巴瘤相比, 其浸润病灶表现为更高的反射性。翼状胬肉显示结膜上皮增厚, 上皮反射亢进, 上皮下楔形高反射组织与被覆上皮被裂隙面分开。睑裂斑表现为上皮轻度增厚, 与翼状胬肉类似, 但病灶不超过角膜边缘。本综述显示, AS-OCT作为一种无创工具, 可应用于眼表肿瘤的鉴别诊断。AS-OCT的局限性主要包括对厚的、角质化和色素性的肿瘤后缘的可视化有限, 以及单次断扫缺乏对大型结膜肿瘤的评估能力。
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05 January 2023
A Correction to this paper has been published: https://doi.org/10.1038/s41433-022-02378-8
14 June 2023
A Correction to this paper has been published: https://doi.org/10.1038/s41433-023-02541-9
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All authors contributed to design of the study, data collection, analysis, interpretation, and writing of the paper. AKG and IM were responsible for the literature search and initial preparation of the manuscript. AKG, IM, and ÖÖG collected and interpreted optical coherence tomography images. AOH, IK, ZG, CCE, and ÖA were responsible for obtaining and interpreting pathological images.
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The original online version of this article was revised: In the legend to Fig 2 the term (B-F) should have read (D-F) The legend to Figure 2 should be read: Conjunctival melanocytic tumours including conjunctival nevus (A–C), primary acquired melanosis (PAM) (D–F), and conjunctival melanoma (G–I).
The original online version of this article was revised: due to a typesetting mistake, the column headings of Table 1 have originally appeared incorrectly. Additionally, the table citation has been corrected from “Table adapted from Medina CA, Plesec T, Singh AD. Optical coherence tomography imaging of ocular and periocular tumours. Br J Ophthalmol. 2014;98 Suppl 2:ii40–ii46” to “Table adapted from Ang M, Baskaran M, Werkmeister RM, Chua J, Schmidl D, Aranha Dos Santos V, et al. Anterior segment optical coherence tomography. Prog Retin Eye Res 2018;66:132–156”.
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Gündüz, A.K., Mirzayev, I., Okcu Heper, A. et al. Anterior segment optical coherence tomography in ocular surface tumours and simulating lesions. Eye 37, 925–937 (2023). https://doi.org/10.1038/s41433-022-02339-1
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DOI: https://doi.org/10.1038/s41433-022-02339-1
