Jebmh.com Original Research Article J. Evid. Based Med. Healthc., pISSN- 2349-2562, eISSN- 2349-2570/ Vol. 4/Issue 88/Nov. 06, 2017 Page 5196 TOUCH IMPRINT CYTOLOGY- A RAPID INTRAOPERATIVE DIAGNOSTIC METHOD FOR OCULAR SURFACE SQUAMOUS NEOPLASIA Gopeswari Hota 1 , Bidisha Mahapatra 2 , Sharmistha Behera 3 1 Assistant Professor, Department of Ophthalmology, Veer Surendra Sai Institute of Medical Sciences and Research. Burla. 2 Postgraduate Resident, Department of Ophthalmology, Veer Surendra Sai Institute of Medical Sciences and Research. Burla. 3 Associate Professor Department of Ophthalmology, Veer Surendra Sai Institute of Medical Sciences and Research. Burla. ABSTRACT BACKGROUND The technique of imprint cytology is a simple, cost effective, rapid technique of intraoperative diagnosis of tumours. It plays a significant role in the rapid diagnosis of the lesions in centres with less developed infrastructure. Objectives of this study were to analyse the accuracy of imprint cytology and thereby to evaluate its diagnostic utility. MATERIALS AND METHODS The prospective study was carried out in a tertiary care hospital. It included 12 cases of ocular surface squamous neoplasia. The cytodiagnosis was correlated with histopathological (HP) diagnosis to evaluate the accuracy of imprint cytology. RESULTS Maximum lesions were of invasive squamous cell carcinoma (50%) followed by intraepithelial neoplasms including dysplasias (33.3%) and carcinoma in situ (16.6%). Overall accuracy of detecting type of lesion was 83.33%. Total discordance with HP diagnosis was 16.6%. CONCLUSION Intraoperative diagnosis using imprint cytology provides a rapid and efficient means of pathological assessment which in experienced hand, is capable of obtaining a high degree of accuracy. KEYWORDS Ocular Surface Squamous Neoplasia, Imprint Cytology, Histopathology. HOW TO CITE THIS ARTICLE: Hota G, Mahapatra B, Behera S. Touch imprint cytology- a rapid intraoperative diagnostic method for ocular surface squamous neoplasia. J. Evid. Based Med. Healthc. 2017; 4(88), 5196-5199. DOI: 10.18410/jebmh/2017/1038 BACKGROUND Ocular surface squamous neoplasia (OSSN) is a broad term encompassing conjunctival intraepithelial neoplastic lesions (CIN) and invasive squamous cell carcinoma (SCC) of conjunctiva and cornea. 1 The term CIN, in vogue today was proposed by Pizarello and Jakobeic, derived from the terminology applied to the intraepithelial cervical malignancies. 2 Clinically, it is difficult to distinguish dysplasia, carcinoma in situ and SCC. Conjunctival squamous cell carcinoma (SCC) is uncommon worldwide, and the incidence varies geographically from 0.2 to 3.5/100,000. 3 OSSN clinically manifest with a very wide spectrum. It includes several forms of epithelial, stromal, caruncular, and secondary tumours. In the clinical practice, comprehensive ophthalmologist, cornea specialist, and an ocular oncologist are commonly confronted with ocular surface tumours and similar looking lesions quite frequently in day to day practice. Predisposing factors for OSSN are exposure to sunlight, HPV type 16 infections, and immunocompromised status such as AIDS. Ocular surface squamous neoplasia is mostly unilateral and rarely bilateral in immunocompromised cases and is seen in middle-aged and older patients. Patient with OSSN often presents with redness and ocular irritation. Vision is affected usually when the lesion encroaches the center of the cornea. The lesion has appearance of being fleshy or nodular, sessile minimally elevated with surface keratin, feeder vessels, and secondary inflammation. The gold standard for the diagnosis of OSSN is the histopathological evaluation of the lesion after an incisional or excisional biopsy. However there are several occasions when the clinician may opt to do diagnostic tests to corroborate the clinical suspicion of OSSN. Histopathologically, mild CIN (dysplasia) is characterized by partial thickness replacement of the epithelium by anaplastic cells that lack normal maturation. Severe CIN is characterized by full thickness replacement of the epithelium by similar cells. A characteristic abrupt demarcation between affected epithelium and normal epithelium is seen in both the variants. Invasive SCC shows a breach in the basement membrane of basal epithelium and is typically a fairly well- differentiated neoplasm composed of abnormal epithelial Financial or Other, Competing Interest: None. Submission 16-10-2017, Peer Review 23-10-2017, Acceptance 02-11-2017, Published 04-11-2017. Corresponding Author: Dr. Bidisha Mahapatra, Room No. 28, Ladies Hostel 2, VSSIMSAR, Burla, PO- Burla, Burla, Sambalpur, Odisha-768017. E-mail: mahapatrabidisha589@gmail.com DOI: 10.18410/jebmh/2017/1038