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Epidemiology of Ocular Surface Squamous Neoplasia in a Veterans Affairs Population

McClellan, Andrew J. MD; McClellan, Allison L. OD; Pezon, Candido F. BS; Karp, Carol L. MD; Feuer, William MS; Galor, Anat MD, MSPH

doi: 10.1097/ICO.0b013e31829e3c80
Clinical Science

Purpose: To evaluate the epidemiology of ocular surface squamous neoplasia (OSSN) and its associated risk factors in a South Florida Veterans Affairs Hospital population.

Methods: Retrospective case–control study. Twenty-eight confirmed cases of OSSN from 24,179 veterans who received care at the Miami Veterans Affairs Healthcare System and affiliated satellite eye clinics between March 1, 2007, and March 1, 2012. Data extracted from the veterans administration database that comprised demographic information and medical diagnosis information [based on International Classification of Disease (ICD-9) codes]. The main outcome measures were the period prevalence of OSSN and identification of factors associated with the presence of disease.

Results: The period prevalence of OSSN in our population was 0.1%. The risk factors studied included UV-related dermatologic diseases (melanoma, squamous and basal cell cancer, and actinic keratosis), UV-related ocular conditions (pterygium), HIV seropositivity, human papilloma virus–related diseases, and tobacco use. The presence of skin malignancy (squamous cell carcinoma and/or basal cell carcinoma) and pterygium was found to be significantly associated with the presence of OSSN [odds ratio, 4.40; 95% confidence interval, 2.03–9.55; P < 0.0005 and odds ratio, 16.2; 95% confidence interval, 7.11–36.9; P < 0.0005, respectively].

Conclusions: The presence of neoplasias and ocular conditions related to sun exposure was the most important risk factor for the occurrence of OSSN in a South Florida Veterans Affairs Healthcare System population consistent with previous epidemiological reports worldwide.

*Miami Veterans Affairs Medical Center, Miami, FL; and

Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami, Miami, FL.

Reprints: Anat Galor, Department of Ophthalmology, Miami VAMC, 1201 NW 16th St, Miami, FL 33125: (e-mail:

Supported by a career development grant from the Veterans Affairs Medical Center (AG), NIH Center Core Grant P30EY014801, Research to Prevent Blindness Unrestricted Grant (Bascom Palmer Eye Institute institutional grants), The Ronald and Alicia Lepke Grant, The Lee and Claire Hager Grant, and The Jimmy and Gaye Bryan Grant (CK). Other financial disclosure unrelated to the study: contributions from Bausch & Lomb (AG).

The authors have no conflicts of interest to disclose.

Received January 29, 2013

Accepted May 30, 2013

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.