High-resolution optical coherence tomography for screening ocular surface tumors: Historical markers and future directions

BACKGROUND High-resolution optical coherence tomography (HR-OCT) has become an essential instrument in the screening and diagnosis of ocular surface neoplasms. Research demonstrates that HR-OCT possesses a diagnostic sensitivity ranging from 85% to 90% for ocular surface squamous neoplasia (OSSN). The connections between HR-OCT features and histological findings have consistently shown robustness, hence increasing the reliability of clinical diagnosis. AIM To examine the existing HR-OCT indicators employed in the identification of common non-benign ocular surface tumors, namely, basal cell carcinoma, OSSN, and melanocytic conjunctival lesions, and to assess their diagnostic efficacy, benefits, and prospective developments. METHODS A thorough literature review was performed to assess the published research on HR-OCT in the diagnosis of ocular surface cancers. Significant attention was given to research that compares HR-OCT characteristics with histopathologic validation, as well as on publications addressing the integration of emerging technologies and artificial intelligence in ocular oncology imaging. RESULTS HR-OCT exhibits elevated diagnostic sensitivity (85%-90%) for identifying OSSN and presents distinct imaging patterns that align closely with histology results. This approach has substantial clinical advantages due to its non-invasive characteristics, improved axial resolution, and real-time imaging capabilities. HR-OCT has demonstrated potential in assessing various lesions, including basal cell carcinoma and melanocytic conjunctival malignancies. CONCLUSION HR-OCT assumes an increasingly vital role in the early identification and clinical management of ocular surface malignancies. With advancements in imaging technology and the integration of artificial intelligence, HR-OCT is anticipated to enhance individualized diagnosis and treatment planning in ocular oncology, hence improving patient outcomes.