Systematic Reviews
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 16, 2025; 13(29): 108046
Published online Oct 16, 2025. doi: 10.12998/wjcc.v13.i29.108046
High-resolution optical coherence tomography for screening ocular surface tumors: Historical markers and future directions
Ehimare Enaholo, Godwin Okoye, Mutali Musa, Ayuba Suleman, Oluwasola Ojo, Roberta Foti, Fabiana D’Esposito, Rosa Giglio, Daniele Tognetto, Caterina Gagliano, Marco Zeppieri
Ehimare Enaholo, Godwin Okoye, Department of Ophthalmology, Centre for Sight Africa Ltd, Nkpor 434101, Nigeria
Godwin Okoye, Mutali Musa, Ayuba Suleman, Department of Ophthalmology, Africa Eye Laser Center Ltd, Benin 300211, Nigeria
Mutali Musa, Department of Optometry, University of Benin, Benin 300283, Nigeria
Oluwasola Ojo, Department of Optometry, University of Ilorin, Ilorin 234031, Nigeria
Roberta Foti, Division of Rheumatology, A.O.U. Policlinico-San Marco, Catania 95123, Italy
Fabiana D’Esposito, Imperial College Ophthalmic Research Group Unit, Imperial College, London NW15QH, United Kingdom
Rosa Giglio, Daniele Tognetto, Marco Zeppieri, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste 34129, Italy
Caterina Gagliano, Department of Medicine and Surgery, University of Enna "Kore", Enna 94100, Italy
Caterina Gagliano, Mediterranean Foundation, G.B. Morgagni, Catania 95100, Italy
Marco Zeppieri, Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
Co-corresponding authors: Caterina Gagliano and Marco Zeppieri.
Author contributions: Enaholo E and Musa M wrote the outline of the manuscript; Enaholo E, Zeppieri M, and Musa M did the research and writing of the manuscript; Zeppieri M and Ayuba S assisted in the writing of the draft and final manuscript; Enaholo E and Okoye G were responsible for the conception and design of the study; Enaholo E, Okoye G, Suleman A, Ojo O, Foti R, D’Esposito F, Giglio R, Tognetto D, Gagliano C, Musa M, and Zeppieri M assisted in the research, writing, and editing of the manuscript; Okoye G contributed to the scientific editing of the manuscript; Musa M, Enaholo E, and Zeppieri M assisted in the editing and critical revisions of the manuscript, and viewed all versions of the manuscript; Gagliano C and Zeppieri M played important and indispensable roles in the data interpretation and manuscript preparation as the co-corresponding authors; All authors provided final approval of the manuscript.
Conflict-of-interest statement: All authors have no conflicts of interest to declare.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marco Zeppieri, MD, PhD, Department of Ophthalmology, University Hospital of Udine, p. le S. Maria della Misericordia 15, Udine 33100, Italy. mark.zeppieri@asufc.sanita.fvg.it
Received: April 9, 2025
Revised: May 5, 2025
Accepted: July 15, 2025
Published online: October 16, 2025
Processing time: 147 Days and 0.7 Hours
Abstract
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.

Keywords: Anterior segment optical coherence tomography; Ocular surface squamous neoplasia; Basal cell carcinoma; Artificial intelligence; Ocular oncology; Non-invasive diagnostics; Deep learning

Core Tip: The emergence of optical coherence tomography (OCT) has given healthcare systems a deeper understanding into tissue systems as related to both the abnormal and normal patient. In the eye, anterior segment OCT is gradually becoming the gold standard for diagnosis and documentation of pathologies in the front of the eye. An understanding of its development, application and uptake is important to the modern-day eye clinician.