Objective To observe the clinical manifestation and ophthalmoscopic image characteristics of uveal metastatic carcinoma.Methods Thirty-six uveal metastatic carcinoma patients (43 eyes) were enrolled in this study.The patients included 21 males and 15 females.The patients' ages ranged from 28 to 71 years,with a mean age of (47.3 ±10.2) years.Seven patients had bilateral carcinoma and 29 patients had unilateral carcinoma.There were 30 patients with lung cancer,three patients with breast cancer,one patient with gastric cancer and two patients without primary tumors.There were 20 patients with known primary cancer,16 patients visited the Department of Ophthalmology first.All the patients were examined documenting visual acuity,intraocular pressure,slit-lamp microscopy and mydriatic fundus examination.Meanwhile,22 patients (26 eyes) were examined using B-type ultrasound and/or color Doppler flow imaging(CDFI).Twelve patients (12 eyes) were examined using fundus fluorescein angiography (FFA) and/or indocyanine green angiography (ICGA).Seventeen patients (22 eyes) were examined using MRI and/or CT.The clinical manifestation and ophthalmoscopic image characteristics of uveal metastatic carcinoma patients were observed.Results Among 43 eyes,four lesions were in the iris,three lesions in the ciliary body and 32 lesions were in the choroid.Fundus examination showed an isolated mass in 26 eyes and more than two masses in nine eyes.Metastatic tumors of the iris and ciliary body often showed irregular cauliflower-like mass with gray-white or meat-red color and abundant vessels.The choroidal metastasis usually demonstrated flat rounded or irregular intraocular masses with gray-yellow or gray-white color in the posterior pole.B-type ultrasound showed ill-defined,flat,and irregular-shaped masses with uneven internal reflectivity.CDFI showed rich blood flow within the tumor.FFA and (or)ICGA showed pinpoint and mottled leaks against hyperfluorescence background.MRI revealed low or middle signal using T1 WI and low signal intensity using T2WI.Conclusions The uveal metastatic carcinoma usually occurs in one eye with an isolated mass.Most of them show a flat gray-yellow mass in posterior choroids and have the primary cancer sites of the lung.FFA and/or ICGA show pinpoint and mottled leaks against hyperfluorescence background.B-type ultrasound and (or) CDFI show ill-defined,flat,and irregular-shaped mass with rich blood flow within the tumor.MRI reveals low signal intensity on T2 WI.%目的 观察葡萄膜转移癌的临床表现和影像检查特征.方法 临床检查确诊的葡萄膜转移癌患者36例43只眼纳入研究.男性21例,女性15例；年龄28～71岁,平均年龄(47.3±10.2)岁；双眼7例,单眼29例.肺癌30例,乳腺癌3例,胃癌1例,未找到原发肿瘤2例.有原发肿瘤病史20例,首诊眼科16例.所有患者均行视力、眼压、裂隙灯显微镜检查及散瞳眼底检查.行眼部B型超声和(或)彩色多普勒超声血流成像(CDFI)检查22例26只眼；荧光素眼底血管造影(FFA)联合吲哚青绿血管造影(ICGA)检查12例12只眼；双眼MRI和(或)CT检查17例22只眼.观察分析患者临床表现和影像检查特征.结果 43只眼中,转移癌位于虹膜者4只眼；睫状体者3只眼；脉络膜者32只眼.玻璃体重度混浊,眼底不能窥见者4只眼.脉络膜脱离32只眼和睫状体3只眼中,眼底单个病灶26只眼,2个及以上病灶9只眼.睫状体和虹膜转移癌表现为睫状体和虹膜上菜花样肉红色或灰白色肿物,表面呈不规则形,肿物内血管丰富.脉络膜转移癌表现为眼底后极部不规则形、圆形灰黄色或灰白色扁平隆起肿物;B型超声和(或)CDFI检查可见后极部扁平形或表面不规则波浪形眼内占位性病变,内回声分布不均匀,瘤体内血流丰富.FFA和(或)联合ICGA检查可见瘤体上有特征性针尖样或点状强荧光；MRI检查可见T1 WI呈与玻璃体一致或稍高信号,T2 WI呈低信号.结论 葡萄膜转移癌以单眼单个病灶多见；大部分位于后极部脉络膜,呈扁平灰黄色隆起.FFA和(或)ICGA检查可见瘤体上有特征性针尖样或点状强荧光；B型超声和(或)CDFI可见扁平不规则实性占位,血流丰富；MRI检查T2 WI呈低信号.
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