Epidemiology of ocular surface squamous neoplasia and squamous papillomas in Hong Kong Chinese: A 10-year review

Abstract

Background/Aims We aim to report the risk factors, clinicopathological characteristics, treatment modalities, and outcomes of ocular surface squamous neoplasia (OSSN) and squamous papilloma (SQP) in a Chinese population. Methods A retrospective cohort study was performed on subjects with histologically proven OSSN and SQP between April 2012 and August 2022 at two hospitals in Hong Kong. Results Fifty eyes of 48 subjects were analysed, of which 24 were OSSN. The overall ten-year annual incidence rate was 0.34 per 100,000 persons. Men were more commonly affected. Moderate-to-severe dysplastic lesions were more frequently associated with pterygia or pinguecula ( p = 0.034), diffuse growth ( p = 0.0027), and involvement of the cornea and limbus (p = 0.0037) than benign lesions. Malignant lesions more frequently involved the fornix ( p = 0.0086) and involved the inferior quadrant, although the latter did not reach statistical significance. There was no shift in surgical treatment patterns between the periods 2012-2016 and 2017-2022. Recurrence-free survival probabilities were 90% at 6 months and 87.0% at 1, 2 and 3 years, with a median follow-up duration of 24 months (IQR 2–48 months). No tumour-related mortality was recorded. Conclusion The incidence of OSSN and SQP has remained stable over the last decade in our locality, where the prevalence of the Human Immunodeficiency Virus infection has been low. Male sex and a history of pterygia and/or pinguecula were associated with OSSN in our population. The majority achieved complete resolution following excision with or without adjuvant therapy.