CARACTERÍSTICAS BIOMICROSCÓPICAS DAS NEOPLASIAS ESCAMOSAS DA SUPERFÍCIE OCULAR EM SERVIÇO DE REFERÊNCIA EM OFTALMOLOGIA, NO BRASIL

Abstract

Background: ocular surface squamous neoplasia (OSSN) rank third in frequency among malignant ocular neoplastic lesions and first among ocular surface malignancies. Due to their wide range of clinical presentations and the lack of standardization in describing biomicroscopic characteristics, distinguishing OSSN from other non-OSSN lesions is challenging. Objective: to characterize the epidemiologic, clinical, histopathologic and biomicroscopic features of OSSN. Methods: epidemiologic, clinical and histopathologic features were extracted from clinical records. Biomicroscopic features were analized by photographs from the biomicroscopic exams of patients in Santa Casa de Belo Horizonte with both OSSN and non-OSSN lesions. Results: OSSN affected older individuals compared to non OSSN lesions. The cornea and nasal limbus were the most commonly affected areas. UV exposure was a frequent factor among those affected. Lesions in the OSSN group included eleven cases of squamous intraepithelial neoplasia, five grade I, five grade II and one grade III, six cases of in situ squamous cell carcinoma (SCC), and four invasive SCCs. The most frequently observed biomicroscopic characteristics of OSSN included the presence of feeder vessels (95%), elevated relief (95%), hairpin vessels (90%), white or yellowish structureless areas (85%), polymorphic vessels (85%), white halos around the vessels (80%), pink backgrounds with vessels (60%), and glomerular vessels (45%). Among these features, only elevated relief, feeder vessels, and pink backgrounds with vessels had statistically similar frequencies compared to non-OSSN lesions. The other findings were more frequently observed in OSSN, with statistical significance. Conclusion: OSSN more frequently affect individuals with a history of UV exposure. They are most commonly located in photoexposed regions of the ocular surface, particularly in the limbus, adjacent bulbar conjunctiva, and cornea. They present clinical characteristics common to non-OSSN lesions, such as elevated relief and feeder vessels. Significantly more frequent biomicroscopic characteristics in OSSN include white or yellowish structureless areas, white halos around vessels, the presence of intrinsic vascularization with hairpin-like vessels, glomerular vessels, and/or polymorphic vessels.