The Ohio State University, College of Medicine, Columbus, OH.
Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL.
Can J Ophthalmol. 2024 Dec;59(6):369-375. doi: 10.1016/j.jcjo.2024.05.029. Epub 2024 Jul 31.
Social determinants of health (SDH) play a crucial role in shaping health outcomes. Few studies have explored the impact of SDH in ocular oncology, looking at differences in disease presentation, treatment choices, and outcomes based on race, ethnicity, socioeconomic status (SES), and insurance status. Retinoblastoma exhibits disparities in survival, with lower-income countries experiencing substantially lower rates compared to high-income countries. In the U.S., racial and SES disparities exist, impacting treatment choices and outcomes in children with retinoblastoma. Disparities in treatment modalities based on race and SES have been reported in uveal melanoma, with non-White and economically disadvantaged patients more likely to undergo primary enucleation. Ocular surface squamous neoplasia (OSSN) exhibits racial and socioeconomic disparities in treatment outcomes. Black patients with OSSN face higher mortality, independent of tumor size, eye laterality, or tumor behavior. Given the rarity, there is no data on disparities in vitreoretinal lymphoma management. When using primary central nervous system lymphoma as a surrogate, management and survival outcomes vary based on factors such as race, socioeconomic status, and insurance status. This article aims to review current literature on disparities in ocular oncology, highlighting the need for granular data to better understand existing gaps in care within ocular oncology.
社会决定因素(SDH)在塑造健康结果方面起着至关重要的作用。很少有研究探讨 SDH 在眼科肿瘤学中的影响,研究着眼于基于种族、族裔、社会经济地位(SES)和保险状况的疾病表现、治疗选择和结果差异。视网膜母细胞瘤的存活率存在差异,低收入国家的存活率明显低于高收入国家。在美国,种族和 SES 差异存在,影响患有视网膜母细胞瘤的儿童的治疗选择和结果。葡萄膜黑色素瘤的治疗方式也存在种族和 SES 差异,非白人和经济弱势群体更有可能接受初次眼球摘除术。眼表鳞状细胞肿瘤(OSSN)在治疗结果方面存在种族和社会经济差异。患有 OSSN 的黑人患者死亡率更高,与肿瘤大小、眼侧、肿瘤行为无关。由于罕见,玻璃体视网膜淋巴瘤管理方面没有差异数据。当使用原发性中枢神经系统淋巴瘤作为替代物时,管理和生存结果因种族、社会经济地位和保险状况等因素而异。本文旨在回顾眼部肿瘤学中存在差异的现有文献,强调需要详细数据来更好地了解眼部肿瘤学中现有护理差距。