Singh A D, De Potter P, Fijal B A, Shields C L, Shields J A, Elston R C
Department of Ophthalmology, University of Florida, Gainesville, USA.
Ophthalmology. 1998 Jan;105(1):195-8. doi: 10.1016/s0161-6420(98)92205-9.
In the white population, an association between oculo(dermal) melanocytosis (ODM) and uveal melanoma is well recognized. However, the lifetime prevalence of uveal melanoma in the ODM population is not known. This study was designed to determine the lifetime prevalence of uveal melanoma among patients with ocular melanocytosis.
Fifty-six white patients manifesting ODM with uveal melanoma formed the basis of the study.
Published prevalence rates of ODM and uveal melanoma were used for calculations using Bayes' theorem.
The lifetime prevalence of uveal melanoma in white patients with ODM is estimated to be 2.6 x 10(-3). The median age at diagnosis of uveal melanoma in the ODM population was similar to a randomly selected population (60.5 years and 62.5 years, respectively). In the vast majority of patients (90%) with ODM-associated uveal melanoma, the uveal melanoma was diagnosed between the ages of 31 years and 80 years.
One of about 400 patients with ODM followed for life is estimated to develop uveal melanoma. Excessive melanocytes in the uveal tract in ODM may provide the biologic basis for susceptibility to the development of uveal melanoma. Patients with ODM should be monitored ophthalmoscopically, especially during the susceptible period, for the development of uveal melanoma. The authors suggest that a national registry of ODM patients be created and prospective data collected to better assess the risk of developing uveal melanoma.
在白种人群中，眼（皮肤）黑素细胞增多症（ODM）与葡萄膜黑色素瘤之间的关联已得到充分认识。然而，ODM人群中葡萄膜黑色素瘤的终生患病率尚不清楚。本研究旨在确定眼黑素细胞增多症患者中葡萄膜黑色素瘤的终生患病率。
56例表现为ODM合并葡萄膜黑色素瘤的白种患者构成了本研究的基础。
使用贝叶斯定理，采用已发表的ODM和葡萄膜黑色素瘤患病率进行计算。
白种ODM患者中葡萄膜黑色素瘤的终生患病率估计为2.6×10⁻³。ODM人群中葡萄膜黑色素瘤的诊断中位年龄与随机选择的人群相似（分别为60.5岁和62.5岁）。在绝大多数（90%）与ODM相关的葡萄膜黑色素瘤患者中，葡萄膜黑色素瘤在31岁至80岁之间被诊断出来。
估计每400例终生随访的ODM患者中约有1例可能发生葡萄膜黑色素瘤。ODM患者葡萄膜中过多的黑素细胞可能为葡萄膜黑色素瘤的易感性提供生物学基础。ODM患者应接受眼底镜检查监测，尤其是在易感期，以观察葡萄膜黑色素瘤的发生。作者建议建立一个ODM患者国家登记处，并收集前瞻性数据，以更好地评估发生葡萄膜黑色素瘤的风险。
