Evaluation of Impression Cytology for Diagnosis of Ocular Surface Squamous Neoplasia in Two Kenyan Tertiary Hospitals.
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INTRODUCTION: Ocular surface squamous neoplasia (OSSN) is a broad term encompassing pre-cancerous and cancerous conditions affecting the ocular surface. Given the non-specific clinical presentation, there is a need for reliable diagnostic tools that can be used in resource-limited settings. This study assessed the diagnostic accuracy of Impression Cytology (IC) in diagnosing OSSN, compared to histopathology, the gold standard. METHODS: A diagnostic accuracy study was conducted involving 40 patients suspected to have OSSN at Kenyatta National Hospital and Kikuyu Hospital. Patients were scheduled for IC followed by surgical excision and Histopathological examination. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were calculated. RESULTS: There were 40 participants, 28 females and 12 males, with a mean age of 40.5 years (range 18-70). IC had a sensitivity of 100%, specificity of 82.1%, accuracy of 87.5%, positive predictive value of 70.6%, and negative predictive value of 100%. CONCLUSION: IC is an effective, minimally invasive diagnostic tool for OSSN, demonstrating high sensitivity and negative predictive value. Its implementation in clinical settings could improve early detection and management of OSSN, particularly in regions with limited access to histopathological services.