mNGS Analysis of Virus and Colonized Bacteria in Ocular Surface Squamous Neoplasia

Abstract Purpose To analyze the correlation between the onset of ocular surface squamous neoplasia (OSSN) and viral infections such as human papillomavirus (HPV), as well as ocular surface colonized pathogenic microorganisms. Methods Three patients who were clinically diagnosed with OSSN and underwent ocular surface tumor resection combined with amniotic membrane transplantation from March 1, 2023 to June 1, 2023 were selected as the study group. Specimens were collected during surgery for pathological examination and metagenomic next-generation sequencing (mNGS) of pathogenic microorganisms. Another three patients diagnosed as corneal leukoplakia who were tested negative for viruses by mNGS after penetrating keratoplasty during the same period were selected as the control group. Results Among the 3 OSSN patients, 1 was male and 2 were female, with an average age of 71.3 ± 4.0 (69–76) years. The OSSN in all 3 cases invaded both the cornea and conjunctiva. In this group, mNGS suggested no detection of viral pathogens in the specimens. However, suspected colonized bacteria were detected in the 2 cases of corneal and conjunctival intraepithelial neoplasia (CIN): Propionibacterium acnes, Moraxella osloensis, Pseudomonas fluorescens, Prevotella melaninogenica, and in the 1 case of squamous cell carcinoma of conjunctiva and cornea (SCC): Propionibacterium acnes. Among the 3 cases of corneal leukoplakia in the control group, mNGS indicated no viral pathogens, but detected suspected colonized bacteria of Propionibacterium acnes, Lactobacillus inerta, Staphylococcus hominis, Staphylococcus cohnii, Staphylococcus epidermidis and Escherichia coli. Conclusion The occurrence of OSSN of the patients in this paper was not related to HPV infection. Nevertheless, the increased presence of colonized bacteria of Moraxella osloensis, Pseudomonas fluorescens and Prevotella melaninogenic, as well as the decreased presence of Lactobacillus inerta, Staphylococcus hominis, Staphylococcus cohnii, Staphylococcus epidermidis and Escherichia coli may be the high-risk factors for OSSN.