Augsburger J J
Oncology Unit, Wills Eye Hospital, Jefferson Medical College, Thomas Jefferson University, Philadelphia.
Trans Am Ophthalmol Soc. 1993;91:147-68; discussion 169-75.
Many, if not most, patients with a suspected small choroidal melanoma are currently managed by observation until tumor enlargement is documented. Current evidence appears to be insufficient to determine the correctness of this approach. A randomized clinical trial that could resolve this issue is probably not feasible. In the absence of satisfactory evidence, the decision about how to manage such patients depends on a subjective benefit-risk analysis that takes into account two competing but indeterminate risks: the risk of inadequate treatment for those patients who have a true melanoma and the risk of excessive treatment for those who have a benign nevus. Technologic advances and development of effective treatment for metastatic disease may eliminate most of the concern that currently accompanies observation as management for such tumors in the future.
许多疑似脉络膜小黑色素瘤的患者（即便不是大多数）目前都是通过观察来处理，直到记录到肿瘤增大。目前的证据似乎不足以确定这种方法的正确性。一项能够解决这个问题的随机临床试验可能并不可行。在缺乏令人满意的证据的情况下，对于如何处理这类患者的决策取决于主观的利弊分析，该分析要考虑到两种相互矛盾但又不确定的风险：对于那些患有真正黑色素瘤的患者治疗不足的风险，以及对于那些患有良性痣的患者过度治疗的风险。技术进步和转移性疾病有效治疗方法的发展可能会消除未来目前伴随将观察作为此类肿瘤处理方式的大部分担忧。
