1
|
Kalua K, Misanjo ES, Lietman TM, Ruder K, Zhong L, Chen C, Liu Y, Yu D, Abraham T, Wu N, Yan D, Hinterwirth A, Doan T, Seitzman GD. Etiologies of Infectious Keratitis in Malawi. Am J Trop Med Hyg 2024; 111:694-697. [PMID: 39013379 PMCID: PMC11376150 DOI: 10.4269/ajtmh.24-0149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 04/30/2024] [Indexed: 07/18/2024] Open
Abstract
Infectious keratitis is a leading cause of corneal blindness worldwide with little information known about causative etiologies in Malawi, Africa. This area is resource-limited with ophthalmologist and microbiology services. The Department of Ophthalmology at the Kamuzu College of Health Sciences in Blantyre, Malawi, is a participating site of an international corneal ulcer consortium, capriCORN (Comprehensive Analysis of Pathogens, Resistomes, and Inflammatory-markers in the CORNea). In this study, 50 patients with corneal ulcers were swabbed for pathogen identification using RNA-sequencing. Corneal trauma was reported in 41% and 19% of the patients worked in agriculture. A pathogen was identified in 58% of the cases. Fungal pathogens predominated, followed by viruses and bacteria. Aspergillus, Fusarium, HSV-1, and Gardnerella were the most common pathogens detected. 50% of patients reported treatment with an antibiotic before presentation. Pathogens unusual for infectious keratitis, such as Subramaniula asteroids, Aureobasidium pullulans, and Gardnerella vaginalis, were also detected.
Collapse
Affiliation(s)
- Khumbo Kalua
- Department of Ophthalmology, Kamuzu College of Health Sciences, Blantyre, Malawi
| | - Esther S Misanjo
- Department of Ophthalmology, Kamuzu College of Health Sciences, Blantyre, Malawi
| | - Thomas M Lietman
- Francis I. Proctor Foundation, University of California, San Francisco, California
- Department of Ophthalmology, University of California, San Francisco, California
| | - Kevin Ruder
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Lina Zhong
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Cindi Chen
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | - YuHeng Liu
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Danny Yu
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Thomas Abraham
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Nathaniel Wu
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Daisy Yan
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Armin Hinterwirth
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Thuy Doan
- Francis I. Proctor Foundation, University of California, San Francisco, California
- Department of Ophthalmology, University of California, San Francisco, California
| | - Gerami D Seitzman
- Francis I. Proctor Foundation, University of California, San Francisco, California
- Department of Ophthalmology, University of California, San Francisco, California
| |
Collapse
|
2
|
Odendaal LN, Andreae C, Sanderson-November M, Zaharie D, Smit DP. The prevalence of human papillomavirus in ocular surface squamous neoplasia in HIV positive and negative patients in a South African population. Infection 2024; 52:1547-1552. [PMID: 38724852 PMCID: PMC11289340 DOI: 10.1007/s15010-024-02289-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 05/01/2024] [Indexed: 08/02/2024]
Abstract
PURPOSE To assess the prevalence and subtypes of Human Papillomavirus (HPV) in Ocular Surface Squamous Neoplasia (OSSN) in Human Immunodeficiency Virus (HIV) positive and negative patients in South Africa. BASIC PROCEDURES This study was a single center retrospective cross-sectional study, conducted at Tygerberg Hospital, Western Cape, South Africa. We assessed 63 histopathologically confirmed OSSN formalin-fixed paraffin-embedded (FFPE) tissue blocks from 2015-2023. The presence of HPV was determined using the Hybrispot Direct Flow Chip Kit. Corresponding clinical data was retrieved from the National Health Laboratory Service (NHLS) central data warehouse. MAIN FINDINGS Of the confirmed OSSN samples, 66.7% tested positive for HPV (95% confidence interval [CI] 54-77.3%). Of the 42 HPV positive samples, 38 (90.5%) had one or more known genotypes detected and 4 had unknown genotypes. The most prevalent subtypes were HPV 11, 16 and 18 (found in 61.9%, 52.4% and 33.3% of HPV positive samples respectively). 88.9% of the lesions biopsied were from HIV positive patients, of whom 56.4% had a CD4 + count of < 200 cells/µL. A lower median CD4 + count was detected among HIV positive patients with invasive squamous cell carcinoma compared to those with moderate dysplasia (p < 0.0198). CONCLUSIONS There is a high prevalence of HPV in OSSN in South Africa. Certain subtypes namely, 11, 16, 18, 31, 33 and 35 may be more carcinogenic. HIV with HPV co-infection may be linked as a causative factor in the development of OSSN.
Collapse
Affiliation(s)
- Loren N Odendaal
- Division of Ophthalmology, Faculty of Medicine and Health Sciences, Stellenbosch University, Room 5053, Clinical Building, Francie Van Zijl Drive, Parow Valley, 7505, South Africa.
| | - Corinna Andreae
- Division of Ophthalmology, Faculty of Medicine and Health Sciences, Stellenbosch University, Room 5053, Clinical Building, Francie Van Zijl Drive, Parow Valley, 7505, South Africa
| | - Micheline Sanderson-November
- Department of Anatomical Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie Van Zijl Drive, Parow Valley, 7505, South Africa
| | - Dan Zaharie
- Department of Anatomical Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie Van Zijl Drive, Parow Valley, 7505, South Africa
| | - Derrick P Smit
- Division of Ophthalmology, Faculty of Medicine and Health Sciences, Stellenbosch University, Room 5053, Clinical Building, Francie Van Zijl Drive, Parow Valley, 7505, South Africa
| |
Collapse
|
3
|
Walia JY, Harocopos GJ, Hong AR. High-risk human papillomavirus-associated corneal/conjunctival intraepithelial neoplasia in a young patient. Am J Ophthalmol Case Rep 2023; 32:101942. [PMID: 37877005 PMCID: PMC10590763 DOI: 10.1016/j.ajoc.2023.101942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 09/22/2023] [Accepted: 10/05/2023] [Indexed: 10/26/2023] Open
Abstract
Purpose To report a case of high-risk human papillomavirus (HPV)-associated corneal/conjunctival intraepithelial neoplasia (CIN) in a 17-year-old fair-skinned male with no other risk factors. Observations A 17-year-old Caucasian male presented with an 18-month history of left eye pain, redness, itchiness, and decreased vision. Examination revealed a leukoplakic nasal limbal/peripheral corneal lesion resistant to topical antibiotic and anti-inflammatory treatments. Excisional biopsy confirmed the diagnosis of CIN, and RNA in situ hybridization testing for high-risk HPV types 16/18 was positive. Subsequent testing of the patient for human immunodeficiency virus (HIV) returned negative. Conclusions and Importance The median age of CIN diagnosis in the United States is in the sixth decade of life and is usually associated with a history of ultraviolet (UV) light exposure. There are reports of CIN in young patients with systemic immunodeficiency, immunosuppression, xeroderma pigmentosum, atopic dermatitis, asthma, and vaping. Here we present a case of high-risk HPV-associated CIN in a young, fair-skinned patient with no other identifiable risk factors.
Collapse
Affiliation(s)
- Jessica Y. Walia
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, MO, USA
| | - George J. Harocopos
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, MO, USA
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Augustine R. Hong
- Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, MO, USA
| |
Collapse
|
4
|
Nergiz D, Süren E, Süren D. The role of HPV in the etiopathogenesis of pterygium and the relationship with recurrence. Int Ophthalmol 2023; 43:3793-3801. [PMID: 37422852 DOI: 10.1007/s10792-023-02791-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 06/22/2023] [Indexed: 07/11/2023]
Abstract
PURPOSE The primary aim of this study was to determine the prevalence of HPV in pterygium with polymerase chain reaction (PCR) testing and to investigate the relationship with clinicopathological factors. A secondary aim was to evaluate the relationship between HPV and the recurrence of pterygium. METHODS The study included 60 patients. PCR analysis was used to determine the presence of HPV. All the patients were followed up in respect of the development of recurrence. Analyses were performed of patient age, pterygium site, specimen and pterygium size, histopathological findings, HPV status, operation technique and postoperative follow-up findings. In the HPV-positive patients, the relationship between HPV subtypes and other factors was evaluated. To determine the risk factors affecting recurrence rates, multivariate Cox regression analysis was applied subsequent to univariate analysis. In the Cox regression model, HPV status, age, sex, specimen size, size and site of pterygium were included among factors that may affect recurrences rates. RESULTS Of the total 60 patients, the HPV-PCR test result could not be analysed in 14 because of an insufficient sample. Of the 46 patients with sufficient material for HPV-PCR analysis, the HPV-PCR result was positive in 15 (32.6%). The HPV subtype most often determined was type 16. No statistically significant relationship was determined between HPV positivity and HPV subtype and age or sex. Recurrence was determined in 10% of all the patients. Of the cases determined with recurrence, 66.7% were HPV positive. According to Kaplan-Meier analysis, the recurrence rates in HPV-positive and HPV-negative patients were 26.7% and 6.5%, respectively. A statistically significant difference was found between two groups in terms of recurrence rates (p: 0.046). According to the results of multivariate Cox regression analysis, though not statistically significant, the risk of recurrence was increased 6.18 times in HPV-positive patients with pterygium compared to HPV-negative ones. CONCLUSION HPV infection may have a role in the development of pterygium and recurrence, but may not be sufficient alone. HPV probably has a role in the development of pterygium by acting together with several co-factors in the multi-stage process.
Collapse
Affiliation(s)
- Döndü Nergiz
- Department of Pathology, Antalya Training and Research Hospital, Kazım Karabekir Street, 07050, Muratpaşa, Antalya, Turkey.
| | - Elçin Süren
- Department of Ophthalmology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Dinç Süren
- Department of Pathology, Health Sciences University, Antalya Training and Research Hospital, Antalya, Turkey
| |
Collapse
|
5
|
Sámano-Hernández L, Y G, González-Márquez H, Corazón-Martínez L, Lucio VM BD. Human papilloma virus presence and its physical status in primary pterygium. Heliyon 2023; 9:e16189. [PMID: 37234612 PMCID: PMC10208819 DOI: 10.1016/j.heliyon.2023.e16189] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/25/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
Pterygium is one of the most frequent pathologies in ophthalmology, and is a benign, overgrowth of fibrovascular tissue, often with a wing-like appearance, from the conjunctiva over the cornea. It is composed of an epithelium and highly vascular, sub-epithelial, loose connective tissue. There is much debate surround the pathogenesis of pterygium and a number of theories have been put forward including genetic instability, cellular proliferation, inflammatory influence, and degeneration of connective tissue, angiogenesis, aberrant apoptosis and viral infection. At present, the involvement of human papillomavirus (HPV) in the genesis of pterygium is controversial, as have reported that HPV is present in 58% of cases, while others have failed to detect HPV in pterygium. In this study, we evaluated the presence and viral genotype of HPV DNA in pterygia and healthy conjunctiva sample, and virus integration into the cellular genome. Forty primary pterygia samples and 12 healthy conjunctiva samples were analyzed to HPV DNA presence by polymerase chain reaction, using MY09/MY11 primers of HPV-L1 gene. Viral genotype was identified by DNA sequence analysis of this amplicon. HPV integration into the cellular genome was analyzed by western blot detecting HPV-L1 capsid protein. Presence of HPV was observed in 19 of the 40 pterygia samples. In contrast, healthy conjunctiva samples were negative. To determine virus type, sequence analyses were performed. Interestingly, 11 out of the 19-pterygium samples were identified as HPV-11 type, meanwhile, the remaining 8 pterygium samples were identified as HPV-18. HPV-L1 capsid protein were found only in 3 out of the 10 samples studied. In conclusion, our study identified the presence of HPV DNA exclusively in pterygium samples and described HPV-11 and -18 genotypes. Our results suggest that HPV may be involved in the pathogenesis of pterygium. On the other hand, the expression of the L1-HPV protein suggests viral integration into the cellular genome.
Collapse
Affiliation(s)
- Leslye Sámano-Hernández
- Microbiology and Ocular Proteomics, Research Unit, Institute of Ophthalmology Fundación de Asistencia Privada Conde de Valenciana, Chimalpopoca, 14 Colonia Obrera, 06800, México City, Mexico
- Doctorado en Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Mexico City, Mexico
| | - Garfias Y
- Cellular Biology, Research Unit, Institute of Ophthalmology Fundación de Asistencia Privada Conde de Valenciana, Chimalpopoca, 14 Colonia Obrera, 06800, México City, Mexico
- Department of Biochemistry, Faculty of Medicine, UNAM, Insurgentes Sur 3000, Coyoacán, 04510, Mexico City, Mexico
| | - Humberto González-Márquez
- Doctorado en Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Mexico City, Mexico
| | - L.A. Corazón-Martínez
- Microbiology and Ocular Proteomics, Research Unit, Institute of Ophthalmology Fundación de Asistencia Privada Conde de Valenciana, Chimalpopoca, 14 Colonia Obrera, 06800, México City, Mexico
| | - Bautista-de Lucio VM
- Microbiology and Ocular Proteomics, Research Unit, Institute of Ophthalmology Fundación de Asistencia Privada Conde de Valenciana, Chimalpopoca, 14 Colonia Obrera, 06800, México City, Mexico
| |
Collapse
|
6
|
Peterson C, Parikh RN, Ahmad MT, Campbell AA, Daoud Y, Mahoney N, Siadati S, Eberhart CG. Detection of Human Papillomavirus in Squamous Lesions of the Conjunctiva Using RNA and DNA In-Situ Hybridization. Int J Mol Sci 2022; 23:ijms23137249. [PMID: 35806252 PMCID: PMC9266440 DOI: 10.3390/ijms23137249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/24/2022] [Accepted: 06/28/2022] [Indexed: 02/04/2023] Open
Abstract
In-situ hybridization provides a convenient and reliable method to detect human papillomavirus (HPV) infection in formalin-fixed paraffin-embedded tissue. Cases of conjunctival papillomas, conjunctival intraepithelial neoplasia (CIN), conjunctival carcinoma in situ (cCIS), and invasive squamous cell carcinoma (SCC), in which low-risk (LR) and/or high-risk (HR) HPV types were evaluated by RNA or DNA in-situ hybridization, were retrospectively identified. LR HPV types were frequently detected in conjunctival papillomas (25/30, 83%), including 17/18 (94%) with RNA probes, compared to 8/12 (75%) with DNA probes. None of the CIN/cCIS or SCC cases were positive for LR HPV by either method. HR HPV was detected by RNA in-situ hybridization in 1/16 (6%) of CIN/cCIS cases and 2/4 (50%) of SCC cases, while DNA in-situ hybridization failed to detect HPV infection in any of the CIN/cCIS lesions. Reactive atypia and dysplasia observed in papillomas was generally associated with the detection of LR HPV types. Collectively, our findings indicate RNA in-situ hybridization may provide a high-sensitivity approach for identifying HPV infection in squamous lesions of the conjunctiva and facilitate the distinction between reactive atypia and true dysplasia. There was no clear association between HPV infection and atopy in papillomas or dysplastic lesions.
Collapse
Affiliation(s)
- Cornelia Peterson
- Department of Molecular and Comparative Pathobiology, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA;
| | - Rupin N. Parikh
- Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (R.N.P.); (M.T.A.); (A.A.C.); (Y.D.); (N.M.)
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA;
| | - Meleha T. Ahmad
- Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (R.N.P.); (M.T.A.); (A.A.C.); (Y.D.); (N.M.)
| | - Ashley A. Campbell
- Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (R.N.P.); (M.T.A.); (A.A.C.); (Y.D.); (N.M.)
| | - Yassine Daoud
- Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (R.N.P.); (M.T.A.); (A.A.C.); (Y.D.); (N.M.)
| | - Nicholas Mahoney
- Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (R.N.P.); (M.T.A.); (A.A.C.); (Y.D.); (N.M.)
| | - Sepideh Siadati
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA;
| | - Charles G. Eberhart
- Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA; (R.N.P.); (M.T.A.); (A.A.C.); (Y.D.); (N.M.)
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA;
- Correspondence: ; Tel.: +1-(410)-502-5185
| |
Collapse
|
7
|
Mastronikolis S, Adamopoulou M, Tsiambas E, Makri OΕ, Pagkalou M, Thomopoulou VK, Georgakopoulos CD. Vascular Endothelial Growth Factor expression patterns in non- Human Papillomavirus - related pterygia: an experimental study on cell spot arrays digital analysis. Curr Eye Res 2022; 47:1003-1008. [PMID: 35322737 DOI: 10.1080/02713683.2022.2058018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE The role of angiogenic factors -such as vascular endothelial growth factor (VEGF) - in development and progression of pterygia lesions remains under investigation. In the current study, we analyzed VEGF protein expression in a series of pterygia and normal conjunctiva epithelia. METHODS Using a liquid based cytology assay, thirty (n = 30) cell specimens were obtained by applying a smooth scraping on conjunctiva epithelia and fixed accordingly. None of them had a history of Human Papillomavirus (HPV) infection. Similarly, the same process was applied also in normal conjunctiva epithelia (n = 10; control group). We constructed five (n = 5) slides each containing eight (n = 8) cell spots. An immunocytochemistry (ICC) assay was implemented. Digital image analysis was also performed for evaluating objectively the corresponding immunostaining intensity levels. RESULTS All the examined pterygia cell samples over expressed the marker. High staining intensity levels were detected in 15/30 (50%), whereas the rest 15/30 (50%) demonstrated moderate expression. Overall VEGF expression was statistically significantly higher in pterygia compared to normal conjunctiva epithelia (p=.0001). Concerning the other parameters, VEGF protein expression did not associate with the gender of the patients (p = 0.518), the presence of recurrent lesion (p = 0.311), the anatomical location (p = 0.191) or with their morphology (p = 0.316). Interestingly, the recurrent lesions demonstrated the highest levels of VEGF expression. CONCLUSIONS VEGF over expression is a frequent event in pterygia playing a potentially central molecular role in the progression of the lesion. Cell spot array analysis -based on liquid cytology- seems to be an innovative, easy to use technique for analyzing a broad variety of molecules in multiple specimens on the same slide by applying different ICC assays.
Collapse
Affiliation(s)
| | - Maria Adamopoulou
- Department of Biomedical Sciences, University of West Attica, Athens, Greece
| | | | - Olga Ε Makri
- Department of Ophthalmology, Medical School, University of Patras, Rion - Achaia, Greece
| | - Marina Pagkalou
- Department of Chemistry, University of Crete, Voutes - Heraklion, Greece
| | | | | |
Collapse
|
8
|
Zhu C, Weiss M, Scribbick FW, Johnson DA, Kheirkhah A. Occurrence of Occult Neoplasia in Pterygium Specimens among Hispanic and Non-Hispanic Patients. Curr Eye Res 2022; 47:978-981. [PMID: 35180019 DOI: 10.1080/02713683.2022.2035403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To determine the role of race and ethnicity in the prevalence of occult ocular surface squamous neoplasia (OSSN) in pterygium specimens. METHODS This retrospective study reviewed pathology reports and medical records of 504 patients who underwent pterygium surgery in South Texas. Those with clinical signs of OSSN were excluded. Clinical data including age, sex, and self-reported race and ethnicity were analyzed to determine risk factors for presence of occult OSSN in pterygium specimens. RESULTS There were 504 specimens; 95.8% were from patients identified as White, 1.8% from African Americans, and 2.4% from Asians. Ethnicity included Hispanic in 71% and non-Hispanic in 29%. Among all specimens, 18 (3.6%) were positive for occult OSSN. The prevalence of occult OSSN in pterygium specimens was higher in Hispanics compared to Non-Hispanics (4.8% versus 0.7%, respectively, P = 0.025). The prevalence of occult OSSN in different races included 8.3% for Asians, 3.5% for Whites, and 0% for African Americans. However, the racial difference did not reach statistical significance (P = 0.57). There were also no statistically significant differences between those with or without occult OSSN regarding age or sex. CONCLUSIONS A significant but low rate of occult OSSN was found in pterygium specimens. The percentage of those with OSSN in pterygium specimens was significantly greater in Hispanics compared to Non-Hispanics. As treatment and prognosis of pterygium and OSSN differ, histopathologic evaluation of all pterygium specimens is warranted.
Collapse
Affiliation(s)
- Christopher Zhu
- Department of Ophthalmology, Long School of Medicine, UT Health San Antonio, San Antonio, Texas, USA
| | - Menachem Weiss
- Department of Ophthalmology, Long School of Medicine, UT Health San Antonio, San Antonio, Texas, USA
| | - Frank W Scribbick
- Department of Ophthalmology, Long School of Medicine, UT Health San Antonio, San Antonio, Texas, USA
| | - Daniel A Johnson
- Department of Ophthalmology, Long School of Medicine, UT Health San Antonio, San Antonio, Texas, USA
| | - Ahmad Kheirkhah
- Department of Ophthalmology, Long School of Medicine, UT Health San Antonio, San Antonio, Texas, USA
| |
Collapse
|
9
|
Abstract
Purpose of review To review and update the latest findings in diagnosis and management of ocular surface squamous neoplasia (OSSN). Recent findings OSSN is the most common anterior segment neoplastic disease process. Several ocular surface imaging techniques have been developed for the early diagnosis and management of clinical and subclinical ocular surface squamous neoplasia, including high-resolution optical coherence tomography (HR-OCT), in vivo confocal microscopy, and ultrasound biomicroscopy. Treatment modalities include both surgical and medical management, with a recent trend towards primary and adjunctive pharmacotherapy. Summary There is increasing use of HR-OCT for the diagnosis and monitoring of clinical and subclinical OSSN lesions. Topical pharmacotherapy agents, including interferon α-2b, 5-fluorouracil, and mitomycin C, have demonstrable efficacy in the treatment of OSSN and their use may be dictated based upon tumor factors, patient factors, cost, and side effect profile. Both surgical excision and adjunctive topical medications have excellent success, with the favored treatment method trending towards topical pharmacotherapy as primary therapy.
Collapse
|
10
|
Chalkia AK, Tseliou M, Bontzos G, Tsakalis NG, Liakopoulos DA, Blazaki S, Sourvinos G, Detorakis ET. Association between HPV detection in swab samples and tissue specimens and ophthalmic pterygium recurrence. Graefes Arch Clin Exp Ophthalmol 2021; 259:3077-3082. [PMID: 34155561 PMCID: PMC8216874 DOI: 10.1007/s00417-021-05267-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/19/2021] [Accepted: 05/31/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To investigate the presence of HPV on the ocular surface after surgical excision of HPV infected pterygia and the possible correlation of HPV with pterygium postoperative recurrence. MATERIALS AND METHODS Both exfoliative pterygium swab samples and respective tissue specimens were received and analyzed with real-time PCR for the detection of HPV-infected pterygia. In addition, swab samples from patients that had HPV-infected pterygia with no recurrence after 1 year of follow-up, as well as swab samples from patients with healthy conjunctiva, were analyzed. RESULTS Forty eyes with pterygium of 40 patients and 40 eyes with normal conjunctiva were included in the study. HPV virus was detected in the tissue specimens of 11 patients (27.5%) and in the swabs of 9 patients (22.5%). The HPV subtypes detected were 33, 39, 45, 56, 59, 66, and 68. The swab test had sensitivity of 81.82% and 100% specificity. In 15 (43%) patients, a bare sclera technique was used for pterygium removal and eleven of these patients showed recurrence of the disease. Surgical excision with use of autologous conjunctival graft was performed in twenty patients and five of them had recurrence. Patients with recurrent disease were 12.41 times more likely to have an HPV-infected pterygium (p = 0.031). Furthermore, from the 11 HPV positive patients, six had no recurrence, 1 year after surgery. In five of them, a swab sample was taken from the site of the surgical excision 1 year after surgery and real-time PCR was negative for HPV presence. CONCLUSION Persistence of HPV infection seems to be correlated with postoperative pterygium recurrence. Further investigation with the use of the minimally invasive proposed swab technique may contribute in the understanding of pterygium pathogenesis and in the development of a more efficient treatment planning.
Collapse
Affiliation(s)
- Aikaterini K Chalkia
- Department of Ophthalmology, University Hospital of Heraklion, Crete, Greece
- Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Melpomeni Tseliou
- Laboratory of Clinical Virology, Faculty of Medicine, University of Crete, Heraklion, Greece
| | | | - Nikolaos G Tsakalis
- Department of Ophthalmology, University Hospital of Heraklion, Crete, Greece
- Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Dimitrios A Liakopoulos
- Department of Ophthalmology, University Hospital of Heraklion, Crete, Greece
- Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Styliani Blazaki
- Department of Ophthalmology, University Hospital of Heraklion, Crete, Greece
- Faculty of Medicine, University of Crete, Heraklion, Greece
| | - Georgios Sourvinos
- Laboratory of Clinical Virology, Faculty of Medicine, University of Crete, Heraklion, Greece
- Department of Virology, University Hospital of Heraklion, Crete, Greece
| | - Efstathios T Detorakis
- Department of Ophthalmology, University Hospital of Heraklion, Crete, Greece
- Laboratory of Clinical Virology, Faculty of Medicine, University of Crete, Heraklion, Greece
| |
Collapse
|
11
|
Naravane AV, Weber J, Barucha G, Hou JH. Acute anterior uveitis after topical interferon for conjunctival intraepithelial neoplasia (CIN). GMS OPHTHALMOLOGY CASES 2021; 11:Doc11. [PMID: 34540523 PMCID: PMC8422938 DOI: 10.3205/oc000184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Objective: Ocular surface squamous neoplasia (OSSN) is the most common type of non-melanocytic ocular surface tumor. Conjunctival intraepithelial neoplasia (CIN) is a type of OSSN that be medically managed by either topical interferon alpha-2b (IFN α-2b), 5-fluorouracil (5-FU), or mitomycin C. While a paradoxical response to IFN α-2b in the HIV population has been reported, we report a case of a paradoxical response in an immunocompetent individual. Methods: A 65-year-old immunocompetent female presents to the clinic with CIN. Results: She is started on topical IFN α-2b, resulting in an unexpected hypopyon, increased corneal epithelial defect, and increased size of the lesion. Switching to topical 5-FU resulted in decreasing size of the CIN lesion and resolution of the epithelial defect. Conclusions: Topical IFN α-2b can produce a paradoxical worsening of CIN lesions in some patients. Providers should be aware of this reaction, as well as the presenting signs and symptoms, to make appropriate treatment changes when treating CIN.
Collapse
Affiliation(s)
- Ameay V. Naravane
- University of Minnesota, Department of Ophthalmology & Visual Neurosciences, Minneapolis, United States
| | - Jacquelyn Weber
- University of Minnesota, Department of Ophthalmology & Visual Neurosciences, Minneapolis, United States
| | | | - Joshua H. Hou
- University of Minnesota, Department of Ophthalmology & Visual Neurosciences, Minneapolis, United States,*To whom correspondence should be addressed: Joshua H. Hou, University of Minnesota, Department of Ophthalmology, Phillips-Wangensteen Building, 9th floor, 516 Delaware St SE, Minneapolis, MN 55455, United States, E-mail:
| |
Collapse
|
12
|
Wang YC, Zhao FK, Liu Q, Yu ZY, Wang J, Zhang JS. Bibliometric analysis and mapping knowledge domain of pterygium: 2000-2019. Int J Ophthalmol 2021; 14:903-914. [PMID: 34150547 DOI: 10.18240/ijo.2021.06.17] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 12/30/2020] [Indexed: 01/09/2023] Open
Abstract
AIM To track the knowledge structure, topics in focus, and trends in emerging research in pterygium in the past 20y. METHODS Base on the Web of Science Core Collection (WoSCC), studies related to pterygium in the past 20y from 2000-2019 have been included. With the help of VOSviewer software, a knowledge map was constructed and the distribution of countries, institutions, journals, and authors in the field of pterygium noted. Meanwhile, using co-citation analysis of references and co-occurrence analysis of keywords, we identified basis and hotspots, thereby obtaining an overview of this field. RESULTS The search retrieved 1516 publications from WoSCC on pterygium published between 2000 and 2019. In the past two decades, the annual number of publications is on the rise and fluctuated a little. Most productive institutions are from Singapore but the most prolific and active country is the United States. Journal Cornea published the most articles and Coroneo MT contributed the most publications on pterygium. From co-occurrence analysis, the keywords formed 3 clusters: 1) surgical therapeutic techniques and adjuvant of pterygium, 2) occurrence process and pathogenesis of pterygium, and 3) epidemiology, and etiology of pterygium formation. These three clusters were consistent with the clustering in co-citation analysis, in which Cluster 1 contained the most references (74 publications, 47.74%), Cluster 2 contained 53 publications, accounting for 34.19%, and Cluster 3 focused on epidemiology with 18.06% of total 155 co-citation publications. CONCLUSION This study demonstrates that the research of pterygium is gradually attracting the attention of scholars and researchers. The interaction between authors, institutions, and countries is lack of. Even though, the research hotspot, distribution, and research status in pterygium in this study could provide valuable information for scholars and researchers.
Collapse
Affiliation(s)
- Yu-Chi Wang
- Department of Ophthalmology, the Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, the Key Laboratory of Lens in Liaoning Province, Shenyang 110000, Liaoning Province, China
| | - Fang-Kun Zhao
- Department of Ophthalmology, the Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, the Key Laboratory of Lens in Liaoning Province, Shenyang 110000, Liaoning Province, China
| | - Qian Liu
- Department of Ophthalmology, the Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, the Key Laboratory of Lens in Liaoning Province, Shenyang 110000, Liaoning Province, China
| | - Zi-Yan Yu
- Department of Ophthalmology, the Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, the Key Laboratory of Lens in Liaoning Province, Shenyang 110000, Liaoning Province, China
| | - Jing Wang
- Cataract Centre, Shenyang Aier Excellent Eye Hospital, Shenyang 110000, Liaoning Province, China.,Aier School of Ophthalmology, Central South University, Changsha 410000, Hunan Province, China
| | - Jin-Song Zhang
- Department of Ophthalmology, the Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, the Key Laboratory of Lens in Liaoning Province, Shenyang 110000, Liaoning Province, China.,Cataract Centre, Shenyang Aier Excellent Eye Hospital, Shenyang 110000, Liaoning Province, China.,Aier School of Ophthalmology, Central South University, Changsha 410000, Hunan Province, China
| |
Collapse
|
13
|
Detorakis ET, Bontzos G, Drakonaki EE, Spandidos DA. Changes in peri-ocular anatomy and physiology in pseudoexfoliation syndrome (Review). Exp Ther Med 2021; 21:650. [PMID: 33968180 PMCID: PMC8097227 DOI: 10.3892/etm.2021.10082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/18/2021] [Indexed: 11/05/2022] Open
Abstract
Pseudoexfoliation syndrome (PEX) is characterized by the deposition of proteinaceous material in the anterior ocular segment (resulting in ophthalmic pathologies such as glaucoma and increased risk of complications in cataract surgery), but also by several systemic manifestations. The involvement of peri-ocular tissues in PEX, including the eyelid skin, lacrimal gland, conjunctiva, orbital fat and vessels, as well as the optic nerve, has been reported by several previous studies. The peri-ocular effects of PEX include the development of eyelid laxity, conjunctival chalasis, tear film abnormalities, pronounced orbital fat atrophy in response to the administration of prostaglandin analogues in pseudoexfoliative glaucoma, deficient orbital vascular supply and biomechanical changes in both the eyeball and the optic nerve. These effects may have important clinical implications, including increased difficulty in cataract surgery, ocular surface disease and eyelid margin malpositions.
Collapse
Affiliation(s)
| | - Georgios Bontzos
- Department of Ophthalmology, Red Cross Hospital, Athens 11526, Greece
| | - Eleni E Drakonaki
- Department of Anatomy, Medical School, European University of Cyprus, Nicosia 1516, Cyprus
| | - Demetrios A Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, Heraklion 71003, Greece
| |
Collapse
|
14
|
Lack of HPV in pterygium with no evidence of autoinoculation and the role of cytokines in pterygium with dry eye. Sci Rep 2021; 11:2842. [PMID: 33531557 PMCID: PMC7854664 DOI: 10.1038/s41598-021-82114-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 01/15/2021] [Indexed: 12/16/2022] Open
Abstract
This study evaluated human papillomavirus's (HPV) role in pterygium pathogenesis, its autoinoculation from genitalia to ocular surface, potential cytokines involved, and crosstalk cytokines between pterygium and dry eye (DE). This cross-sectional study enrolled 25 healthy controls (HCs) and 116 pterygium patients. Four subgroups of pterygium and DE were used in cytokine evaluations. Conjunctival and pterygium swabs and first-void urine samples (i.e., genitalia samples) were collected for HPV DNA detection using real-time polymerase chain reaction. Tear cytokines interleukin (IL)-6, IL-18, and vascular endothelial growth factor (VEGF) in tears were evaluated. No HPV DNA was detected in conjunctival or pterygium swabs. No association was found between HPV DNA in urine samples and that from conjunctival or pterygium swabs. Tear VEGF levels were significantly higher in pterygium patients than in HCs, with no markedly different levels between primary and recurrent pterygia. Tear IL-6, IL-18, and tear VEGF were significantly higher in participants with DE, regardless of pterygium status. In conclusion, HPV infection was not a pathogenic factor of pterygia. The hypothesis of HPV transmitting from the genitals to ocular surfaces was nullified. Tear VEGF was involved in both pterygia and DE, whereas tear IL-6 and IL-18 played roles only in DE.
Collapse
|
15
|
Shen J, Wu J, Yang Y, Wang P, Luo T, Guo Y, Zhao J, Dai W, Han Y, Zhu P, Wu Q, Li W, Chen A, Xue C, Xia X. The paradoxical problem with COVID-19 ocular infection: Moderate clinical manifestation and potential infection risk. Comput Struct Biotechnol J 2021; 19:1063-1071. [PMID: 33613871 PMCID: PMC7881169 DOI: 10.1016/j.csbj.2021.01.039] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 01/19/2021] [Accepted: 01/23/2021] [Indexed: 01/08/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which induced mainly the respiratory damage also caused ocular surface symptoms. However, the detailed description of ocular manifestations, severity fluctuations in confirmed COVID-19 adult patients still lacked. We analyzed onset clinical symptoms and duration, ocular symptoms, needs for medication, outcomes in 28 conjunctivitis patients who were extracted from 3198 COVID-19 patients hospitalized in Huoshenshan Hospital and Taikangtongji Hospital, Wuhan, China. The expression levels of ACE2, TMPRSS2, ANPEP, DPP4, NRP1 on fetal and adult ocular surface and mouse lacrimal glands were assessed by single cell seq analysis. Our results indicated that conjunctivitis was a rare and self-limited complication in adults with COVID-19 while the existence of coronavirus receptors on human ocular surface and mouse lacrimal glands indicated the risk of SARS-CoV-2 infection. Our research firstly examined SARS-CoV-2 receptors, including the new discovered one, NRP1, on the fetal ocular surface and in the mouse lacrimal glands.
Collapse
Affiliation(s)
- Jiawei Shen
- COVID-19 Research Center, Institute of Laboratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing Clinical College of Southern Medical University, Nanjing, Jiangsu 210002, China
- Department of Ophthalmology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu 210002, China
| | - Jian Wu
- COVID-19 Research Center, Institute of Laboratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing Clinical College of Southern Medical University, Nanjing, Jiangsu 210002, China
| | - Yang Yang
- COVID-19 Research Center, Institute of Laboratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing Clinical College of Southern Medical University, Nanjing, Jiangsu 210002, China
| | - Pengcheng Wang
- Department of Clinical Laboratory, The 901th Hospital of the Joint Logistics Support Force of PLA, Hefei, Anhui 230031, China
- Department of Clinical Laboratory, Taikang Tongji Hospital, Wuhan, Hubei 430050, China
| | - Tao Luo
- COVID-19 Research Center, Institute of Laboratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing Clinical College of Southern Medical University, Nanjing, Jiangsu 210002, China
| | - Yanju Guo
- COVID-19 Research Center, Institute of Laboratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing Clinical College of Southern Medical University, Nanjing, Jiangsu 210002, China
| | - Jun Zhao
- COVID-19 Research Center, Institute of Laboratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing Clinical College of Southern Medical University, Nanjing, Jiangsu 210002, China
| | - Wei Dai
- COVID-19 Research Center, Institute of Laboratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing Clinical College of Southern Medical University, Nanjing, Jiangsu 210002, China
| | - Ying Han
- COVID-19 Research Center, Institute of Laboratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing Clinical College of Southern Medical University, Nanjing, Jiangsu 210002, China
| | - Peiran Zhu
- COVID-19 Research Center, Institute of Laboratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing Clinical College of Southern Medical University, Nanjing, Jiangsu 210002, China
| | - Qiuyue Wu
- COVID-19 Research Center, Institute of Laboratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing Clinical College of Southern Medical University, Nanjing, Jiangsu 210002, China
| | - Weiwei Li
- COVID-19 Research Center, Institute of Laboratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing Clinical College of Southern Medical University, Nanjing, Jiangsu 210002, China
| | - Andrew Chen
- Jericho High School, 99 Cedar Swamp Rd, Jericho, NY 11753, USA
| | - Chunyan Xue
- Department of Ophthalmology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu 210002, China
- Corresponding authors at: Department of Ophthalmology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu 210002, China (C. Xue). COVID-19 Research Center, Institute of Laboratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing Clinical College of Southern Medical University, Nanjing, Jiangsu 210002, China (X. Xia).
| | - Xinyi Xia
- COVID-19 Research Center, Institute of Laboratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing Clinical College of Southern Medical University, Nanjing, Jiangsu 210002, China
- Joint Expert Group for COVID-19, Department of Laboratory Medicine, Wuhan Huoshenshan Hospital, Wuhan, Hubei 430100, China
- Corresponding authors at: Department of Ophthalmology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu 210002, China (C. Xue). COVID-19 Research Center, Institute of Laboratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing Clinical College of Southern Medical University, Nanjing, Jiangsu 210002, China (X. Xia).
| |
Collapse
|
16
|
Chowdhury Z, Nongrum B, Rajbongshi C. Synchronous eyelid oncocytoma and conjunctival intraepithelial neoplasia. AUTOPSY AND CASE REPORTS 2021; 11:e2020235. [PMID: 34277494 PMCID: PMC8101682 DOI: 10.4322/acr.2020.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 09/30/2020] [Indexed: 11/23/2022] Open
Abstract
Oncocytoma of the eyelid is a rare neoplasm. Oncocytoma associated with an ocular surface squamous neoplasm, namely conjunctival intraepithelial neoplasia, is very hard to find in the literature. Herein we report a case of a 53-year-old male who presented with a swelling in the right lower lid over the last 6 years, along with a growth in the conjunctiva of the same eye for the last 2 years and encroaching upon the cornea for the last 4 months. Excision biopsy of the lower lid mass showed histopathological features consistent with oncocytoma. The conjunctival tissue revealed conjunctival intraepithelial neoplasia 3 (severe dysplasia). This case documents a rare synchronous dual ocular neoplasia, a very unlikely coexistence of oncocytoma with conjunctival intraepithelial neoplasia.
Collapse
Affiliation(s)
- Zachariah Chowdhury
- North Eastern Indira Gandhi Regional Institute of Health & Medical Sciences, Department of Pathology, Shillong, Meghalaya, India
| | - Benjamin Nongrum
- North Eastern Indira Gandhi Regional Institute of Health & Medical Sciences, Department of Ophthalmology, Shillong, Meghalaya, India
| | - Chandana Rajbongshi
- North Eastern Indira Gandhi Regional Institute of Health & Medical Sciences, Department of Pathology, Shillong, Meghalaya, India
| |
Collapse
|
17
|
Carrilho C, Miu C, Kim Y, Karki S, Balmaceda A, Challa B, Diamond S, Monteiro E, Marole E, Lorenzoni C, Zambujo Y, Liu YT, Schooley RT, Lin JH. p16 Expression Correlates with Invasive Ocular Surface Squamous Neoplasms in HIV-Infected Mozambicans. Ocul Oncol Pathol 2020; 6:123-128. [PMID: 32258020 PMCID: PMC7109427 DOI: 10.1159/000502096] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 07/12/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND p16 immunohistochemistry is widely used to diagnose human papillomavirus (HPV)-related squamous neoplasms of cervix, anogenital, head, and neck tissues. The incidence of these HPV-related squamous neoplasms is markedly increased in the HIV-infected population. Ocular surface squamous neoplasia (OSSN) is also more common in HIV-infected patients. However, the expression pattern of p16 in OSSN among HIV-infected patients is unclear. Here, we examined the expression of p16 in OSSN surgical excisions collected from a large HIV-infected cohort from -Mozambique. METHODS OSSN surgical tissue specimens were collected from 75 Mozambican patients. Formalin-fixed, paraffin-embedded tissue blocks from these OSSNs were sectioned, stained with hematoxylin and eosin (H&E), and p16 expression by immunohistochemistry. H&E slides were reviewed to determine if OSSNs were noninvasive conjunctival intraepithelial neoplasms or invasive squamous cell carcinomas (SCC). Cases were classified as p16 positive or negative based on diffuse nuclear and cytoplasmic expression of p16 in neoplastic cells. RESULTS p16 positivity was found in a minority of OSSN cases (14/75). p16 positivity was significantly associated with the invasive SCC type of OSSN in HIV-infected patients (p value of 0.026). CONCLUSIONS The majority of OSSNs in our HIV-infected cohort do not express p16. However, those cases that are p16-positive are significantly more likely to be the invasive SCC form of OSSN. We propose that p16 expression may identify more aggressive OSSNs in HIV-infected populations.
Collapse
Affiliation(s)
- Carla Carrilho
- Department of Pathology, Eduardo Mondlane University, Maputo, Mozambique
- Service of Pathology, Maputo Central Hospital, Maputo, Mozambique
| | - Chau Miu
- Department of Pathology, University of California San Diego, La Jolla, California, USA
| | - Yeji Kim
- Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Susan Karki
- Department of Pathology, University of California San Diego, La Jolla, California, USA
| | - Alexandra Balmaceda
- Department of Pathology, University of California San Diego, La Jolla, California, USA
| | - Bindu Challa
- Department of Pathology, University of California San Diego, La Jolla, California, USA
| | - Scott Diamond
- Department of Pathology, University of California Los Angeles, Los Angeles, California, USA
| | - Eliane Monteiro
- Service of Pathology, Maputo Central Hospital, Maputo, Mozambique
| | - Evelia Marole
- Service of Ophthalmology, Maputo Central Hospital, Maputo, Mozambique
| | - Cesaltina Lorenzoni
- Department of Pathology, Eduardo Mondlane University, Maputo, Mozambique
- Service of Pathology, Maputo Central Hospital, Maputo, Mozambique
- Ministério da Saúde, Programa Nacional de Controlo do Cancro, Maputo, Mozambique
| | - Yolanda Zambujo
- Service of Ophthalmology, Maputo Central Hospital, Maputo, Mozambique
| | - Yu-Tsueng Liu
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Robert T. Schooley
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Jonathan H. Lin
- Service of Pathology, Maputo Central Hospital, Maputo, Mozambique
- Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
- VA San Diego Healthcare System, San Diego, California, USA
- Department of Ophthalmology, Stanford University, Stanford, California, USA
- Department of Pathology, Stanford University, Stanford, California, USA
- VA Palo Alto Healthcare System, Palo Alto, California, USA
| |
Collapse
|