Skip to main content
. Author manuscript; available in PMC: 2022 Sep 7.
Published in final edited form as: Ocul Surf. 2020 Apr 25;18(4):926–935. doi: 10.1016/j.jtos.2020.03.009

Figure 9. A 38-year-old male patient with OSSN with papillomatous and leukoplakic features involving limbus and cornea.

Figure 9.

(A) Slit-lamp photograph showed highly elevated OSSN with leukoplakia at the head, and papillary tail. White dashed arrow shows the cross-sectional cut. (B) The cross-sectional image reveals dramatically thickened epithelium on the cornea and conjunctiva (asterisk) with an abrupt transition from normal to abnormal (arrow). The yellow line shows the bottom boundary of OSSN. The red line shows the sub-epithelial tissue (200 μm) underneath the tumor. (C) Cross-sectional OCT detects the blood flow signals in the superficial layers of the elevated epithelium and the sub-epithelial tissue under the limbal portion of the OSSN. Note the shadow from the hyper-reflective thick lesion diminishes the blood flow signals within the OSSN. (D) The tumor thickness map depicts the thickness of the tumor, demonstrating that it is thickest at the elevated leukoplakic head. (E) Overlay of the enface angiograph with grayscale slit-lamp illustrates the vessels on the ocular surface in relation to the slit-lamp view. Note that vessels are not visualized under the leukoplakic head. (F) The enface angiograph of OSSN and epithelium adjacent to OSSN shows a high density of vessels within the conjunctival/limbal part of the OSSN. No vasculature in the epithelium of the leukoplakic head was noted, only shadowing. (G) The enface angiograph also demonstrates dense vessels in the sub-epithelial tissue under the OSSN at the tumor edge and the surrounding tissue.

(H) The merged image from the angiographic enface images (F and G) shows the vessels within the tumor OSSN (red) and under the tumor in the sub-epithelial tissue (green). Note the limitation of the OCTA in the setting of the dense leukoplakia.

OSSN, ocular surface squamous neoplasia. Dashed white lines (D, F, G, and H) indicate the tumor boundary. Curve dashed yellow line (D, F, G, and H) indicates the limbus.