Coverslip scrape cytology (CSSC): Novel technique for OSSN diagnosis
Year: 2023
Type: article
Abstract: Dear Editor, Ocular Surface squamous neoplasia (OSSN) is a broad entity encompassing a spectrum of squamous neoplasms of conjunctiva and cornea. The history of OSSN dates back to 1860 when it was first described by Von Graefe.[1] It’s an important pathological entity which closely mimics common conjunctival and corneal surface pathologies like pinguecula, pterygium, conjunctival granulomas, and cysts.[2] Conjunctival imprint cytology (CIC) offers valuable clues for the diagnosis and management of OSSN. The technique encompasses the use of a membrane filter paper to pick up a layer of cells from the ocular surface. Egbert demonstrated successful use with absorbent filter paper and established it as a diagnostic tool.[3] Nylon paper and plastic devices have also been used as alternatives to collect epithelia.[4] Nonavailability of the specialized filter paper led us to devise a simple yet effective way of diagnosing cases of OSSN. We resorted to the edge of a cover slip inclined obliquely to the surface of the lesion and gently scraped it under topical anesthesia (0.5% proparacaine) and immediately put it on the glass slide for staining [Video Clip 1] This can be done under ambient room illumination. If the patient is cooperative and keeps the gaze steady, a wire speculum may also not be necessary. However, we used in our cases of OSSN [Fig. 1a] to ensure no reflex closure of the eye. The results were extremely gratifying with the cases of OSSN showing the presence of dysplastic cells on papanicolaou staining [Fig. 1b]. {"href":"Single Video Player","role":"media-player-id","content-type":"play-in-place","position":"float","orientation":"portrait","label":"Video Clip 1","caption":"","object-id":[{"pub-id-type":"doi","id":""},{"pub-id-type":"other","content-type":"media-stream-id","id":"1_w8mpgjou"},{"pub-id-type":"other","content-type":"media-source","id":"Kaltura"}]} Figure 1: (a): Greyish, lobulated, elevated mass overlying conjunctiva and cornea on which CSSC was performed. (b): Presence of dysplastic cells revealed on papanicolaou stainingCover Slip Scrape Cytology (CSSC) has various advantages like it is cost effective, easily available, less cumbersome, reflex lacrimation doesn’t affect yield of cells, and less time-consuming as no staining of any filter paper is required and deeper layers are also picked. It is a simple and novel technique to help diagnose OSSN with one of the most readily available tools in the armamentarium of ocular pathology. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
Source: Indian Journal of Ophthalmology
Authors: Agrima Bhatia, Santosh Kumar
Institution: Command Hospital Air Force
Language: English
Subfield: Ophthalmology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4386923637