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High-Frequency Ultrasonographic Evaluation of Conjunctival Intraepithelial Neoplasia and Squamous Cell Carcinoma
Paul T. Finger, MD;
Hoai Viet Tran, MD;
Roger E. Turbin, MD;
Henry D. Perry, MD;
David H. Abramson, MD;
Kimberly Chin, OD;
Robert Della Rocca, MD;
Robert Ritch, MD
Arch Ophthalmol. 2003;121:168-172.
Objective To evaluate the high-frequency B-scan ultrasonographic characteristics of squamous conjunctival neoplasia (conjunctival intraepithelial neoplasia and squamous cell carcinoma).
Methods Each of 11 patients was examined with 20- and/or 50-MHz ultrasonography in a retrospective consecutive case series.
Main Outcome Measures Ultrasonographic findings with clinical and histopathologic correlations.
Results Eleven eyes of 11 patients (8 men) were affected. Disease involved the right eye in 6 (55%) of the patients and the left eye in 5 (45%) of the patients; it was multifocal in 5 (45%) of the eyes. All tumors extended to, or primarily involved, the limbal conjunctiva. One patient developed superficial spread overlying a functioning partial-thickness filtering bleb, 1 developed intraocular extension, 1 developed scleral invasion, and 3 developed orbital involvement before treatment. Results of ultrasonographic examinations showed that the superficial aspect of the smaller limbal tumors appeared as fusiform thickening of the conjunctiva. In all patients, the tumor surface was highly reflective in contrast to the characteristically low reflectivity seen within the tumor stroma. Intraocular tumor extension was variably reflective, but evidenced by blunting of the anterior chamber angle and thickening of the uvea. Orbital extension was viewed as low reflective tumor extension into the relatively hyperechoic orbital tissues.
Conclusions High-frequency ultrasonography may be used to assess the extent of squamous conjunctival neoplasia. While the 50-MHz system offered better resolution, 20-MHz ultrasonography allowed for a wider and deeper field of view. High-frequency ultrasonography was useful in determining tumor thickness, shape, and internal reflectivity, and especially in revealing tumor extension into the sclera, eye, and orbit.
From The New York Eye and Ear Infirmary (Drs Finger, Tran, Abramson, Della Rocca, and Ritch), The New York Eye Cancer Center (Drs Finger and Chin), and the Departments of Ophthalmology, New York University School of Medicine (Dr Finger) and Cornell University Medical College (Dr Abramson), New York; the Departments of Ophthalmology, New York Medical College, Valhalla (Drs Tran, Della Rocca, and Ritch), and the University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark (Dr Turbin); and North Shore Health System, Manhasset, NY (Dr Perry).
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