Diagnosis of Ocular Surface Lesions Using Ultra–High-Resolution Optical Coherence Tomography

Purpose To assess the use of ultra–high-resolution (UHR) optical coherence tomography (OCT) in the diagnosis of ocular surface lesions. Design Prospective, noncomparative, interventional case series. Participants Fifty-four eyes of 53 consecutive patients with biopsy-proven ocular surface lesions: 8 primary acquired melanosis lesions, 5 amelanotic melanoma lesions, 2 nevi, 19 ocular surface squamous neoplasia lesions, 1 histiocytosis lesion, 6 conjunctival lymphoma lesions, 2 conjunctival amyloidosis lesions, and 11 pterygia lesions. Intervention Ultra–high-resolution OCT imaging of the ocular surface lesions. Main Outcome Measures Clinical course and photographs, UHR OCT image, and histopathologic findings. Results Ultra–high-resolution OCT images of all examined ocular surface lesions showed close correlation with the obtained histopathologic specimens. When clinical differential diagnosis of ocular surface lesions was broad, UHR OCT images provided optical signs indicating a more specific diagnosis and management. In cases of amelanotic melanoma, conjunctival amyloidosis, and primary histiocytosis and in 1 case of ocular surface squamous neoplasia, UHR OCT was instrumental in guiding the diagnosis. In those cases, UHR OCT suggested that the presumed clinical diagnosis was incorrect and favored a diagnosis that later was confirmed by histopathologic examination. Conclusions Correlations between UHR OCT and histopathologic findings confirm that UHR OCT is an adjunctive diagnostic method that can provide a noninvasive means to help guide diagnosis and management of ocular surface lesions. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.