Introduction

Ocular surface masqueraders encompass any ocular surface lesion masquerading as another ocular surface lesion. High resolution optical coherence tomography (HR-OCT) has emerged as an adjunctive tool to clinical acumen. This study's purpose is to evaluate the utility of HR-OCT images in guiding the diagnosis and management of those lesions.

Material and methods

22 individuals with a clinically ambiguous ocular surface lesion with slit lamp photographs (SLP), HR-OCT images, and histopathological examination were included in the study. The presumptive clinical diagnosis based on SLP was compared to the diagnosis suggested by HR-OCT findings and to definitive diagnosis by histopathology. The main outcome of this study was the frequency in which HR-OCT findings guided the clinician to the correct diagnosis.

Results

7 lesions were epithelial, 3 had an epithelial and a subepithelial component, and 12 were subepithelial. HR-OCT was most effective in discerning lesion location, successfully identifying the location in 100% of cases. Classic HR-OCT findings were detected in 68.2% of cases while suggestive features were detected in 31.8% of cases. The epithelial lesions' mean epithelial thickness was 265.4 ± 140.6 μm, the subepithelial lesions' mean was 58.0 ± 25.0 μm, and the combined lesions’ mean was 140.0 ± 70.0 μm. The epithelium was significantly thicker in epithelial lesions compared to subepithelial and combined lesions. By ROC analysis we identified that using a cut off of 156 μm, the sensitivity was 86% and the specificity was 93%.

Discussion

HR-OCT can be a valuable diagnostic tool, assisting in the differentiation of ambiguous ocular surface pathologies by providing a cross-sectional, morphological image of the lesion.

中文翻译：

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高分辨率光学相干断层扫描（HR-OCT）在眼表伪装者诊断中的应用

 介绍

眼表面伪装者涵盖伪装成另一眼表面病变的任何眼表面病变。高分辨率光学相干断层扫描 (HR-OCT) 已成为临床智慧的辅助工具。本研究的目的是评估 HR-OCT 图像在指导这些病变的诊断和治疗方面的效用。

 材料与方法

该研究纳入了 22 名临床上具有模糊眼表病变的个体，这些患者通过裂隙灯照片 (SLP)、HR-OCT 图像和组织病理学检查进行了检查。将基于 SLP 的假定临床诊断与 HR-OCT 结果建议的诊断以及组织病理学的明确诊断进行比较。这项研究的主要结果是 HR-OCT 结果指导临床医生做出正确诊断的频率。

 结果

7 个病变为上皮，3 个具有上皮和上皮下成分，12 个为上皮下。 HR-OCT 在识别病变位置方面最为有效，100% 的病例都能成功识别位置。在 68.2% 的病例中检测到经典 HR-OCT 结果，在 31.8% 的病例中检测到提示性特征。上皮病变平均上皮厚度为265.4±140.6μm，上皮下病变平均为58.0±25.0μm，合并病变平均为140.0±70.0μm。与上皮下病变和组合病变相比，上皮病变中的上皮明显更厚。通过 ROC 分析，我们发现使用 156 μm 的截止值，敏感性为 86%，特异性为 93%。

 讨论

HR-OCT 可以成为一种有价值的诊断工具，通过提供病变的横截面形态学图像来帮助区分模糊的眼表病理。