Ocular surface squamous neoplasia with 360° limbal involvement: A comparative study of 130 patients

This is the authors' abstract. We don't add key points for this paper.

Purpose To describe the risk factors, clinical features and management outcomes of ocular surface squamous neoplasia (OSSN) with 360° of limbal involvement (360-OSSN). Methods Retrospective comparative study. Results Of 1250 patients diagnosed with OSSN during the study period, 30 (2%) had 360-OSSN. A total of 100 patients of OSSN with segmental limbal involvement (SL-OSSN) were included for comparison. 360-OSSN patients more often had longer duration of symptoms (mean, 17 months vs 8 months; p, 0.003), prior misdiagnosis (17% vs 6%, p, 0.13) and prior intervention (47% vs 13%; p, 0.0002) than patients with SL-OSSN. 360-OSSN tumors were more extensive (mean diameter, 24mm vs 8 mm; p < 0.0001), had diffuse ocular surface involvement (63% vs 3%, p < 0.0001), scleral fixity (57% vs 16%; p < 0.0001), corneal/scleral melt (17% vs 0%; p, 0.0005), intraocular tumor extension (17% vs 0%; p, 0.003), orbital tumor extension (33% vs 1%; p < 0.0001), and advanced T stage at presentation (Tis: 37% vs 76%, T1: 0% vs 15%; T2: 7% vs 4%; T3: 27% vs 4%; T4: 30% vs 1%; p < 0.001). Over a mean follow-up of 15 months in patients with 360-OSSN and 13 months in those with SL-OSSN, lymph node metastasis (8% vs 0%; p, 0.05) and distant metastasis (4% vs 0%; p, 0.23) was more common in 360-OSSN group vs SL-OSSN group. Conclusion Risk factors of 360-OSSN include prolonged symptoms, prior misdiagnosis and prior intervention. It represents an advanced form of disease with larger, diffuse lesions, propensity for corneo-scleral melt and invasive disease which requires aggressive management.