Retrospective study of ocular surface squamous neoplasia

Background: Ocular surface squamous neoplasia (OSSN) encompasses the conditions of simple dysplasia to carcinoma in situ to invasive squamous cell carcinoma. it has a high rate of recurrence after treatment and the potential to metastasize. The present retrospective study was aimed at further defining the characteristics and clinical course of OSSN. Methods: With ethical approval, the records of all major pathology laboratories in Queensland were surveyed. Two hundred and eighty-eight cases were identified: 155 dysplasia, 71 carcinomas in situ and 62 invasive squamous cell carcinoma. The records were analysed and an attempt was made to contact and re-examine the patients. Results: Ocular surface squamous neoplasia occurs mainly in males (78.5%) with a mean age of 60.1 years (range 20-88 years). They present as irritation (40.1%) and are located usually at the limbus (87.8%). The majority of OSSN are treated by simple excision (87.5%), after which there is a high rate of recurrence (23.3%). The main predictors for recurrence include histological grade of the lesion, corneal location and larger size (> 2 mm). Conclusions: Management of OSSN requires adequate excision and careful follow up to monitor any recurrence. As with other ultraviolet light-related conditions, preventative measures must remain the key to disease control.