Agreement between in vivo confocal scanning laser microscopy with a handheld microscope and histology in eyelid and conjunctival tumours

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Abstract

Purpose

By providing non-invasive pseudo histology, in vivo confocal microscopy (IVCM) has been proven efficient in the diagnosis and treatment management of numerous diseases in dermatology and in ophthalmology for the ocular surface. Although it is only complementary to classical histology it allows quicker decisions. At present, both ophthalmology IVCM available are nevertheless not fully convenient for the exploration of the whole conjunctival surface nor for the entire eyelids, because of their bulk and their limited mobility. Aim: to study the reliability of a dermatological handheld IVCM for eyelid and conjunctival tumours

Methods

Thirty-one tumours were analysed using the handheld dermatological IVCM Vivascope 3000 (Lucid Inc, NY, MAVIG GmbH, Germany) equipped with 830nm class IB laser. IVCM diagnosis was made by an ophthalmologist and a dermatologist with a standardized reading grid. Whenever surgery was necessary, tumours were analysed by pathologists blind to the IVCM diagnosis. Agreement between both diagnoses was determined by an independent observer, who calculated sensitivity, specificity, predictive pos value, and predictive neg value

Results

All tumours were accessible. Overall scores were Se=1, Sp=0.45, PPV=0.75, PNV=1, for conjunctiva Se=1, Sp=0.4, PPV=0.571, PNV=1, for eyelids Se=1, Sp=1, PPV=1, PNV=1, and for eyelid margin Se=1, Sp=0.67, PPV=0.75, PNV=1

Conclusion

The handheld IVCM is perfectly adapted to the exploration of the entire conjunctival and eyelid system. Grant: GIRCI Rhone Alpes Auvergne 2012 No financial interest for all authors

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