Background: Anterior high-resolution optical coherence tomography (HR-OCT) is a novel non-invasive in vivo\nimaging modality that can assist in the diagnosis and management of various ophthalmic pathologies. The\nimplementation of diagnosing ocular surface lesions has been explored in previous studies, successfully revealing\nspecific signs in some ocular lesions. This case report aims to exhibit a case of corneal squamous hyperplasia\ndiagnosed via anterior HR-OCT, prior to surgical intervention.\nCase presentation: A 69 year-old male had blurred vision and foreign body sensation OD for several weeks. A\nrapidly-grown corneal mass was presented, showing an appearance of a grayish flesh-colored mass with elastic\ntexture. Large vessels supplying the mass were also found. Anterior HR-OCT was performed, and the results\nsuggested the lesion be benign hyperplasia. Superficial keratectomy was done, and the pathologic report showed\nmild-appearing epithelial squamous hyperplasia, which confirmed the analysis via anterior HR-OCT.\nConclusion: In the categorization by Nanji, et al. of corneal surface diseases using anterior OCT, the comparative\nepithelial thickness (normal range: 47-68 microm); inferior border obscuration of epithelium (normal or benign inferior\nborder: no shadowing); reflectivity of epithelial layer (normal: not hyper-reflective); abrupt transition (normal: no\nhorizontally abrupt transition); and sub-epithelium analysis vary between benign and malignant lesions (normal:\ndemarcated anterior to Bowmanâ??s layer), and the differences are systemically sorted. We applied all these\ncharacteristics to our patient as guidance, and the measurement results indicated the lesion be a benign lesion,\nwhich is consistent with the tissue pathology. Anterior HR-OCT is overall a non-invasive and timely method capable\nof assisting the diagnosis of ocular surface disease, predicting the qualities of a lesion, and determining the followup\ntreatment plan.
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