Murphy S F, Mahl C F, Bloom S M
Retina Associates, Louisville, Kentucky.
Optom Clin. 1993;3(3):63-77.
Choroidal nevi are found on routine fundus evaluations in 1% to 2% of patients. It is felt that these usually benign lesions are the precursors of choroidal malignant melanomas. The incidence of choroidal malignant melanoma in the United States is approximately 6 cases per 1 million persons per year. Diagnosis is multifactorial, based on the tumor's funduscopic, angiographic, and ultrasonographic appearance. Once a melanoma is diagnosed in a patient, a complete metastatic workup is performed. A small tumor is observed for change. Medium-sized tumors are treated with radioactive plaque therapy, external beam radiation, or enucleation. Large tumors are treated with enucleation with or without external beam radiation. Studies are underway to establish the optimum form of treatment.
在1%至2%的患者进行常规眼底检查时可发现脉络膜痣。人们认为这些通常为良性的病变是脉络膜恶性黑色素瘤的前身。在美国，脉络膜恶性黑色素瘤的发病率约为每年每100万人中有6例。诊断是多因素的，基于肿瘤的眼底镜、血管造影和超声检查表现。一旦在患者中诊断出黑色素瘤，就要进行全面的转移灶检查。小肿瘤需观察其变化。中等大小的肿瘤采用放射性敷贴疗法、外照射放疗或眼球摘除术治疗。大肿瘤采用眼球摘除术，可联合或不联合外照射放疗。目前正在进行研究以确定最佳的治疗方式。
