Handheld reflectance in vivo confocal microscopy for the diagnosis of conjunctival tumors

Purpose We evaluated whether the handheld in vivo confocal microscope (IVCM) that has been recently developed for the study of skin tumors is suitable for the diagnosis of conjunctival tumors. Methods Prospective study, observational case series. We prospectively evaluated the IVCM features of 53 conjunctival lesions clinically suspicious of tumors of 46 patients referred to our University Hospital, by using the handheld device (vivascope 3000, Caliber/Mavig). Twenty-three lesions were excised (3 nevi, 10 melanomas, 5 squamous cell carcinoma, 2 lymphomas and 3 pinguecula/pterygium) while the other 30, presenting no IVCM malignant features, were under follow-up for at least 1 year. Clinical, IVCM and histological diagnosis were compared. Sensitivity and specificity of the IVCM for the diagnosis of conjunctival malignant tumors was calculated using as reference 1) the histolological diagnosis and 2) the histological diagnosis plus the clinical diagnosis at follow-up greater than one year. Results IVCM showed sensitivity and specificity for malignant tumors of 100% using both methods. Conclusion IVCM with a handheld dermatology-dedicated microscope can play a role in the non-invasive diagnosis of conjunctival lesions. Further studies should be performed to better define the diagnostic ability of this technique. Grants: GIRCI2012