Objective: This study aimed to assess the demographic, clinical, histological classifications, and anterior segment optical coherence tomography (AS-OCT) features of conjunctival malignancies. The goal was to identify factors associated with tumor malignancy.
Materials and Methods: This retrospective analysis included 37 patients with conjunctival tumors. Data collected comprised age, gender, tumor coloration, histological type, location, corneal involvement, subepithelial reflectivity of the lesion on AS-OCT, lesion homogeneity on AS-OCT, and the presence of intralesional cysts on AS-OCT. Statistical analysis was performed using chi-square and t-tests, with a significance level of α < 0.05. The study protocol was approved by the Erciyes University Health Sciences Research Ethics Committee (Approval Number: 2025/365, Date: 09.07.2025).
Results: Malignant tumors were identified in significantly older patients. No significant gender differences were found regarding malignancy. Amelanotic appearance was significantly more common in malignant tumors. The types of tumors identified included conjunctival nevus, conjunctival ocular surface squamous neoplasia (OSSN), conjunctival lymphoma, conjunctival melanoma, and conjunctival cyst. No significant relationship was found between tumor location and malignancy. Corneal involvement was significantly associated with malignancy. Malignant tumors were significantly larger than benign tumors. On AS-OCT, malignant tumors exhibited a hyporeflective subepithelial lesion with homogeneous internal reflectivity. Although benign tumors contained more intralesional cysts on AS-OCT, this finding was not statistically significant.
Conclusion: Conjunctival tumors exhibit various characteristics. Advanced age, amelanotic pigmentation, corneal involvement, and a hyporeflective homogeneous lesion on AS-OCT are significant indicators of malignancy, highlighting the importance of detailed examination and increased vigilance.