脉络膜恶性黑色素瘤的诊断主要依赖于眼底镜下的表现。尽管近来在荧光素血管造影,放射性磷~(32)试验和超声波等诊断技术上的改进,但误诊率还是很高的。所以,对任何有利于诊断的临床症状应予考虑。近来对恶性黑色素瘤的视网膜色素上皮变化予以更多注意。色素上皮是一种高度反应的组织,在许多脉络膜视网膜疾病中趋向于发生萎缩、增生和迁移。在某些恶性黑色素瘤中,趋于形成成纤维样细胞层或聚积的肥大细胞。电子显微镜下和组织化学方法在该类细胞中可见有黑色素和脂褐质颗粒。临床上,这些细胞表现为肿瘤上的橙色色素团。位于恶性黑色素瘤顶部的视网膜易发生囊样变性和萎缩。此外,视网膜脱离常伴有恶性黑色素瘤,如此则其视网膜 The diagnosis of choroidal malignant melanoma mainly depends on the performance of fundus. Despite recent improvements in diagnostic techniques such as fluorescein angiography, radioactive phosphorus (32) testing and ultrasound, the misdiagnosis rate is still high. Therefore, any diagnosis of clinical symptoms should be considered. Recently, attention has been paid to the change of retinal pigment epithelium in malignant melanoma. Pigment epithelium is a highly reactive tissue that tends to shrink, proliferate, and migrate in many chorioretinal diseases. In some malignant melanomas, mast cells that tend to form fibroblast-like layers or accumulate. Electron microscopy and histochemical methods are found in these cells with melanin and lipofuscin particles. Clinically, these cells appear as tumor clusters of orange pigment. The retina located on the top of malignant melanoma is prone to cystoid degeneration and atrophy. In addition, retinal detachment often accompanied by malignant melanoma, so the retina