Author Block: Sonia Anchouche, Jiaru Liu, Georges Nassrallah, Jean Deschenes

Author Disclosure Block: S. Anchouche: None. J. Liu: None. G. Nassrallah: None. J. Deschenes: Funded grants or clinical trials; National Institutes of Health (NIH) (Grant Funding), National Eye Institute (NEI).

Title:The Assessment of Quality of Life in Patients with a Diagnosis of Uveal Melanoma

Abstract Body:

Purpose: Uveal melanoma is the most common adult intraocular malignancy in the United States. At present, there exists a multitude of uveal melanoma treatment options ranging from globe-preserving methods like plaque radiotherapy to enucleation. Although there have been significant advances in the treatment of primary uveal melanoma, none of the available treatment modalities have been shown to have a significantly superior impact on mortality. Hence, the quality of life and visual functioning post treatment serve as key factors in selecting the appropriate management plan for these patients. The aim of this study is to examine the quality of life of patients treated for uveal melanomas and to review the assessment tools used in the literature.
Study Design: Systematic Review
Methods: A search strategy was employed using the National Library of Medicine (PubMed), Embed, Ovid online, and Cochrane databases to identify all articles addressing the quality of life of patients with uveal melanoma. We included all English, original retrospective or prospective studies published between January 2003 to September 2019 in which the primary outcome was the health-related quality of life (HRQOL) of patients with treated or untreated uveal melanoma, with or without metastasis.
Results: Our search strategy resulted in 69 articles, of which 39 articles were retrieved following title and abstract screening. Twenty articles were included in this study. A total of 3618 patients with iris, ciliary body or choroidal melanoma were included in this review. On average, each study employed 2 different assessment tools to quantify the quality of life of uveal melanoma patients. Overall, physical functioning and mental well-being are impaired in uveal melanoma patients after treatment compared to the general population. The extent of the impairment decreases with time, and HRQOL is comparable to the general population as early as 6 months post-treatment. 6/12 studies comparing treatment options reported no statistical difference in physical functioning between treatments. 5/12 studies reported better visual function with radiation therapy compared to enucleation, two of which described no difference between the two options at long term. Anxiety is more prevalent than depression after most types of treatment, and both decrease to less than 10% at 1-year follow-up.
Conclusions: Overall, there is no significant difference in the long-term quality of life of patients with uveal melanoma between different treatment groups. At short term, there is better physical functioning and emotional well-being associated with radiotherapy compared to enucleation. A combination of QoL assessment tools is commonly used in order to adequately address the physical limitations of vision impairment as well as the psychosocial impact of the disease and treatment on patients.