Detection of malignancy in ocular surface lesions by inverse spectroscopic optical coherence tomography and two-photon autofluorescence

Hyunjoo Jean Lee, Lei Zhang, Sui Zhang, Ji Yi

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Advanced imaging is increasingly important in the diagnosis of ocular surface malignancy. Inverse spectroscopic optical coherence tomography (ISOCT) and two-photon autofluorescence microscopy (2P-AF) are emerging techniques capable of quantifying ultrastructural and metabolic changes, respectively. We aimed to detect malignancy in ocular surface lesions using ISOCT and 2P-AF. Methods: Portions of excised specimens from patients undergoing conjunctival biopsy at Boston Medical Center were imaged by ISOCT and/or 2P-AF, and submitted for histologic diagnosis. Lesions were categorized as malignant, premalignant (with dysplasia) or benign. ISOCT and 2P-AF findings were compared between categories. Results: Fourteen specimens from 13 patients were collected. The IS-OCT marker D was 2.2-fold higher in combined malignant and premalignant (4.27 ± 0.28, n = 3) versus benign (1.92 ± 0.26, n = 11) lesions (P = 9 X 104). ISOCT markers µs and µb were not significantly different. By 2P-AF, the redox ratio was 0.24-fold lower in premalignant (0.11 ± 0.004, n = 2) versus benign (0.45 ± 0.04, n = 9) lesions (P = 1.08 X 105). Conclusions: Conjunctival lesions with higher malignant potential had higher D and lower redox ratios. Higher D can correlate with ultrastructural changes associated with malignancy, similar to what has been seen in cancers of the gut mucosa. Lower redox ratios can suggest the presence of the Warburg effect, which is associated with tumorigenesis. Translational Relevance: IS-OCT and 2P-AF can potentially be applied to the detection of malignancy or malignant potential in ocular surface lesions. ISOCT allows for the detection of nanoscale ultrastructural changes that are not resolvable by conventional OCT.

Original languageEnglish (US)
Article number16
JournalTranslational Vision Science and Technology
Volume8
Issue number3
DOIs
StatePublished - May 2019
Externally publishedYes

Keywords

  • Auto-fluorescence
  • Conjunctival tumors
  • Inverse spectroscopic optical coherence tomography
  • OCT
  • OSSN
  • Ocular surface
  • Two-photon microscopy

ASJC Scopus subject areas

  • Biomedical Engineering
  • Ophthalmology

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