Clinical Topics

Military Risks for Ocular Surface Squamous Neoplasia

by U.S. Medicine

September 22, 2019

MIAMI—While a variety of risk factors have been evaluated in ocular surface squamous neoplasia, few studies have assessed risk factors specific to the armed forces veteran population.

A report in the journal Eye and Vision reported on the retrospective case-control study on 55 patients and 55 age-matched controls with biopsy-proven ocular surface squamous neoplasia.1

All patients were from the Miami VA Hospital Eye Clinic, and researchers from the facility sought to investigate potential risk factors encountered by veterans, including service-specific exposures.

The study team suggested that veteran-specific risk factors included:

  • Ionizing radiation exposure,
  • Agent Orange exposure,
  • Deployment to Southwest Asia, and
  • Exposure to the series of biochemical warfare tests known as Project Shipboard Hazard and Defense.

Results found that the strongest risk factor for ocular surface squamous neoplasia was lifetime sun exposure both directly assessed via historical quantification of exposure by dermatology practitioners (Odds Ratio (OR) 5.4, 95% Confidence Interval (CI) 2.27–12.847, p < 0.005), and using the surrogate markers of basal cell carcinoma (OR 3.157, 95% CI 1.286–7.748, p= 0.010) and pingueculae (OR 5.267, 95% CI 2.104-13.186, p < 0.005).

Researchers added that, of the veteran-specific risk factors, Agent Orange exposure and Southwest Asia deployment were not found to be associated with an increased risk of ocular surface squamous neoplasia.

At the same time, exposure to ionizing radiation and involvement in Project Shipboard Hazard and Defense were not documented among any cases or controls.

“The results of our study are consistent with prior established risk factors, namely highlighting the important role of sun exposure in ocular surface squamous neoplasia among veterans,” study authors wrote.

  1. Smith LM, Lamba S, Karp CL, Galor A. Epidemiology of ocular surface squamous neoplasia in veterans: a retrospective case-control study. Eye Vis (Lond). 2019 May 14;6:14. doi: 10.1186/s40662-019-0138-1. eCollection 2019. PubMed PMID:31131286; PubMed Central PMCID: PMC6524260.


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