Anterior segment OCT and confocal microscopy findings in atypical corneal intraepithelial neoplasia

Eric K. Chin, Dennis E. Cortés, Alexander Lam, Mark J Mannis

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Purpose: To report a case of biopsy-proven corneal intraepithelial neoplasia (CIN) diagnosed and followed clinically using highresolution anterior segment optical coherence tomography (AS-OCT) and in vivo confocal microscopy (IVCM). Methods: Observational case report. Results: A 57-year-old man presented with decreased vision in the right eye for 2 months before presentation. His best-corrected visual acuity was 20/70 in the affected eye, and the slit-lamp examination revealed superficial opacification of the anterior cornea originating from the temporal limbus with a "leopard-spot" pattern more centrally. The lesion was excised at his 2-month follow-up, and the histological examination revealed squamous dysplasia consistent with CIN. Visual acuity improved, and the slit-lamp examination revealed barely visible residual disease at the temporal limbus. However, AS-OCT showed a thicker and highly reflective epithelial layer near the temporal limbus, similar to initial presentation, highlighting this residual disease. IVCM demonstrated dysplastic cells consistent with residual disease. Therefore, we treated the patient with topical interferon alpha-2b (1 million IU/mL) 4 times daily in the affected eye. At 3-month follow-up, the patient's best-corrected visual acuity was 20/20 in the affected eye with persistent but improved residual disease adjacent to the temporal limbus. In the mid-periphery of the inferonasal cornea, focal areas of iatrogenic linear scarring were confirmed to be limited to the anterior stroma by AS-OCT and IVCM at 6-month follow-up. Conclusions: AS-OCT and IVCM are noninvasive techniques that can be used to diagnose and aid in the management of CIN, which may present as subclinical disease through slit-lamp biomicroscopy alone.

Original languageEnglish (US)
Pages (from-to)875-879
Number of pages5
JournalCornea
Volume32
Issue number6
DOIs
StatePublished - Jun 2013

Fingerprint

Confocal Microscopy
Optical Coherence Tomography
Visual Acuity
interferon alfa-2b
Neoplasms
Cornea
Panthera
Interferon-alpha
Cicatrix
Biopsy
Intravital Microscopy
Slit Lamp Microscopy

Keywords

  • Anterior segment optical coherence tomography
  • Conjunctival intraepithelial neoplasia
  • Corneal intraepithelial neoplasia
  • In vivo confocal microscopy
  • Ocular surface squamous neoplasia

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Anterior segment OCT and confocal microscopy findings in atypical corneal intraepithelial neoplasia. / Chin, Eric K.; Cortés, Dennis E.; Lam, Alexander; Mannis, Mark J.

In: Cornea, Vol. 32, No. 6, 06.2013, p. 875-879.

Research output: Contribution to journalArticle

Chin, Eric K. ; Cortés, Dennis E. ; Lam, Alexander ; Mannis, Mark J. / Anterior segment OCT and confocal microscopy findings in atypical corneal intraepithelial neoplasia. In: Cornea. 2013 ; Vol. 32, No. 6. pp. 875-879.
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abstract = "Purpose: To report a case of biopsy-proven corneal intraepithelial neoplasia (CIN) diagnosed and followed clinically using highresolution anterior segment optical coherence tomography (AS-OCT) and in vivo confocal microscopy (IVCM). Methods: Observational case report. Results: A 57-year-old man presented with decreased vision in the right eye for 2 months before presentation. His best-corrected visual acuity was 20/70 in the affected eye, and the slit-lamp examination revealed superficial opacification of the anterior cornea originating from the temporal limbus with a {"}leopard-spot{"} pattern more centrally. The lesion was excised at his 2-month follow-up, and the histological examination revealed squamous dysplasia consistent with CIN. Visual acuity improved, and the slit-lamp examination revealed barely visible residual disease at the temporal limbus. However, AS-OCT showed a thicker and highly reflective epithelial layer near the temporal limbus, similar to initial presentation, highlighting this residual disease. IVCM demonstrated dysplastic cells consistent with residual disease. Therefore, we treated the patient with topical interferon alpha-2b (1 million IU/mL) 4 times daily in the affected eye. At 3-month follow-up, the patient's best-corrected visual acuity was 20/20 in the affected eye with persistent but improved residual disease adjacent to the temporal limbus. In the mid-periphery of the inferonasal cornea, focal areas of iatrogenic linear scarring were confirmed to be limited to the anterior stroma by AS-OCT and IVCM at 6-month follow-up. Conclusions: AS-OCT and IVCM are noninvasive techniques that can be used to diagnose and aid in the management of CIN, which may present as subclinical disease through slit-lamp biomicroscopy alone.",
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AB - Purpose: To report a case of biopsy-proven corneal intraepithelial neoplasia (CIN) diagnosed and followed clinically using highresolution anterior segment optical coherence tomography (AS-OCT) and in vivo confocal microscopy (IVCM). Methods: Observational case report. Results: A 57-year-old man presented with decreased vision in the right eye for 2 months before presentation. His best-corrected visual acuity was 20/70 in the affected eye, and the slit-lamp examination revealed superficial opacification of the anterior cornea originating from the temporal limbus with a "leopard-spot" pattern more centrally. The lesion was excised at his 2-month follow-up, and the histological examination revealed squamous dysplasia consistent with CIN. Visual acuity improved, and the slit-lamp examination revealed barely visible residual disease at the temporal limbus. However, AS-OCT showed a thicker and highly reflective epithelial layer near the temporal limbus, similar to initial presentation, highlighting this residual disease. IVCM demonstrated dysplastic cells consistent with residual disease. Therefore, we treated the patient with topical interferon alpha-2b (1 million IU/mL) 4 times daily in the affected eye. At 3-month follow-up, the patient's best-corrected visual acuity was 20/20 in the affected eye with persistent but improved residual disease adjacent to the temporal limbus. In the mid-periphery of the inferonasal cornea, focal areas of iatrogenic linear scarring were confirmed to be limited to the anterior stroma by AS-OCT and IVCM at 6-month follow-up. Conclusions: AS-OCT and IVCM are noninvasive techniques that can be used to diagnose and aid in the management of CIN, which may present as subclinical disease through slit-lamp biomicroscopy alone.

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