Sneed S R, Byrne S F, Mieler W F, Nicholson D H, Olsen K, Hughes J R
W.K. Kellogg Eye Center, Department of Ophthalmology, University of Michigan, Ann Arbor.
Ophthalmology. 1991 Jun;98(6):963-70. doi: 10.1016/s0161-6420(91)32195-x.
The association of choroidal detachment with malignant choroidal tumors is not well recognized. The authors' experience with six cases suggests that choroidal detachment may be associated with both metastatic tumors and choroidal melanoma. In two of these cases, the choroidal or retinal detachment was so massive that echography was necessary to detect the underlying tumor. Three patients presented with painful visual loss, and three patients presented with painless visual loss or a visual field defect. In one patient, the correct diagnosis and appropriate treatment of the choroidal metastasis with external radiation relieved the patient's pain and improved visual acuity from 1/200 to 20/35. Metastatic and primary uveal malignant tumors should be added to the list of causes of choroidal detachment and can be excluded only after thorough clinical, and often echographic, examination.
脉络膜脱离与脉络膜恶性肿瘤之间的关联尚未得到充分认识。作者对6例病例的经验表明，脉络膜脱离可能与转移性肿瘤和脉络膜黑色素瘤均有关联。在其中2例病例中，脉络膜或视网膜脱离非常严重，以至于需要超声检查才能发现潜在的肿瘤。3例患者表现为疼痛性视力丧失，3例患者表现为无痛性视力丧失或视野缺损。在1例患者中，对脉络膜转移瘤进行正确诊断并采用外照射进行适当治疗后，患者的疼痛得到缓解，视力从1/200提高到了20/35。转移性和原发性葡萄膜恶性肿瘤应被列入脉络膜脱离的病因清单中，只有经过全面的临床检查，且通常还需超声检查后才能排除。
