Tomografia de Coerência Ótica do Segmento Anterior no Diagnóstico e Tratamento de Neoplasia Difusa de Células Escamosas da Conjuntiva com Mitomicina C Tópica: Relato de Caso

Ocular surface squamous neoplasia (OSSN) is the most common non-pigmented malignancy of the ocular surface. Interest in new, non-invasive diagnostic modalities and conservative management options has grown in recent years. We describe a challenging case of a 75-year-old man who presented with a large, diffuse, papilliform conjunctival lesion extending along the limbus from 6 to 3 clock hours in the right eye. Anterior-segment optical coherence tomography (AS-OCT) imaging revealed a thickened and hyperreflective epithelium, with an abrupt transition between normal and abnormal epithelium, suggestive of OSSN. Topical chemotherapy with mitomycin-C (MMC) was proposed as primary treatment given the risks associated with surgical excision. A total of four cycles were completed until clinical regression of the lesion was achieved, which was confirmed by AS-OCT. Topical MMC therapy showed to be a safe and efficient treatment option in diffuse OSSN, with AS-OCT having an important role in diagnosis, treatment guidance, and long-term monitoring of the patient.