光相干断层扫描技术在眼表鳞状上皮瘤诊疗中的应用及展望

Application and prospect of optical coherence tomography in the diagnosis and management of ocular surface squamous neoplasia

眼前节光相干断层扫描技术(AS-OCT)作为一种无创性检查手段,具有检测肿瘤性上皮病变的巨大潜力。依据AS-OCT上的特征性表现,可在多种眼表疾病中检测出眼表鳞状上皮瘤(OSSN)的存在,其诊断效果堪比病理组织活检。随着技术的发展,AS-OCT成像模式已从时域OCT发展到具有更高外显率和分辨率的频域OCT,其呈现的高质量图像有助于精细辨别OSSN的良恶性,提高OSSN的检出率,完善眼表肿瘤的鉴别诊断,从而提高OSSN的诊断效率。此外,在监测OSSN复发及化疗评估等临床管理阶段,AS-OCT可辅助优化治疗方案,有效监测疾病的转归。本文就OSSN的形态学表现、OSSN各种辅助检查的优劣性、AS-OCT的发展、OSSN在AS-OCT上的特异表现、AS-OCT在非典型OSSN中的应用、AS-OCT在OSSN诊疗中的应用及局限性进行综述。

As a non-invasive examination method,anterior segment optical coherence tomography(AS-OCT)has huge potential in detecting neoplastic epithelial lesion.With AS-OCT,detection and differentiation of ocular surface squamous neoplasia(OSSN)within ocular surface pathologies can be achieved and the diagnosis rate is comparable to that of biopsy.With the development of technology,AS-OCT imaging mode has developed from time-domain OCT to spectral-domain OCT with higher penetrance and resolution,the high-quality images of which are helpful to distinguish the benign and malignant OSSN,enhance the detection rate of OSSN,improve the differentiation of ocular surface tumors,and thus improve the diagnostic accuracy of OSSN.In addition,AS-OCT can help optimize the treatment regimen and effectively monitor the outcome of the disease in the clinical management stage,such as monitoring the recurrence of OSSN and evaluating chemotherapy.In this article,the morphological features of OSSN,the advantages and disadvantages of OSSN auxiliary examinations,the development of AS-OCT,the specific manifestation of OSSN on AS-OCT,the application of OCT in atypical OSSN,as well as the value and limitation of AS-OCT in the diagnosis and management of OSSN were reviewed.