The epidemiology of ocular surface squamous neoplasia in a Veterans Affairs population

PURPOSE: To evaluate the epidemiology of ocular surface squamous neoplasia (OSSN) and its associated risk factors in a South Florida Veterans Affairs Hospital population. DESIGN: Retrospective case-control study. METHODS: PARTICIPANTS: 28 confirmed cases of OSSN from 24,179 veterans who received care at the Miami Veterans Affairs Healthcare System (VA) and affiliated satellite eye clinics between March 1, 2007, and March 1, 2012. METHODS: Data extracted from the veterans administration database comprised of demographic information and medical diagnosis information (based on International Classification of Disease (ICD-9) codes). MAIN OUTCOME MEASURES: 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%. Studied risk factors included ultra-violet (UV)-related dermatologic diseases (melanoma, squamous and basal cell cancer, and actinic keratosis), UV-related ocular conditions (pterygium). human immunodeficiency virus (HIV) seropositivity, human papilloma virus (HPV)-related diseases, and tobacco use. The presence of a skin malignancy (squamous cell carcinoma (SCC) and/or basal cell carcinoma (BCC)) and pterygium were found to be significantly associated with the presence of OSSN (odds ratio (OR) 4.40, 95% confidence interval (CI) 2.03–9.55, p <0.0005 and OR 16.2 95% CI 7.11–36.9, p <0.0005, respectively). CONCLUSIONS: The presence of neoplasias and ocular conditions related to sun exposure were the most important risk factors for the presence of OSSN in a South Florida VA population consistent with previous epidemiological reports worldwide