Gass J D
Trans Sect Ophthalmol Am Acad Ophthalmol Otolaryngol. 1977 Jan-Feb;83(1):19-48.
Failure to appreciate the variability in the natural course of choroidal nevi (benign melanomas) has caused the adoption of a misleading cytologic classification of malignant melanomas. This classification is not based on adequate clinical observation, reliable cytologic criteria for malignancy, or sufficient autopsy information. The available evidence suggests that spindle A tumors are benign and that spindel B tumors, although capable of local destruction of the eye, metastasize infrequently. The risk of observation of small melanocytic tumors must be weighed against the risk that early enucleation or other forms of therapy may not favorably affect prognosis. The clinical observations to date at the Bascom Palmer Eye Institute indicate that the risks of observation are low.
未能认识到脉络膜痣（良性黑色素瘤）自然病程的变异性，导致采用了一种误导性的恶性黑色素瘤细胞学分类方法。这种分类并非基于充分的临床观察、可靠的恶性细胞学标准或足够的尸检信息。现有证据表明，梭形A肿瘤是良性的，而梭形B肿瘤虽然能够局部破坏眼睛，但很少发生转移。对于小的黑素细胞瘤进行观察的风险必须与早期眼球摘除或其他治疗形式可能无法改善预后的风险相权衡。巴斯科姆·帕尔默眼科研究所目前的临床观察表明，观察的风险很低。
