目的 :了解老年黄斑变性伴眼底出血与脉络膜恶性黑色素瘤的超声显像鉴别诊断要点。方法 :应用 B超检查 ,观察两种疾病的声像图特征及随访其改变。结果 :老年黄斑变性伴眼底出血声像图表现为眼底前扁长圆形或长条形的中等或高回声区 ,病变前表面均有短的局限性视网膜脱离光带。脉络膜恶性黑色素瘤声像图表现为半圆形或圆形强回声光团 ,有挖空现象、球后组织声影 ,部分病例有脉络膜凹陷。结论 :应用 B超检查可以鉴别这两种疾病 ,对某些难以确诊的病例 ,经过随访检查可明确诊断 Objective : To understand the main points of differential diagnosis of age-related macular degeneration with fundus hemorrhage and choroidal melanoma. Methods : B-ultrasound examination was used to observe the sonographic features of the two diseases and follow-up changes. RESULTS: The visual appearance of age-related macular degeneration combined with fundus retinal hemorrhage was in the middle or hyperechoic region of prosthetic oblong or elongate anterior surface of the fundus. There was a short focal retinal detachment band on the anterior surface of the lesion. The acoustic image of choroidal melanoma showed a semicircular or round strong echogenic light mass, with hollowing out, retrobulbar tissue shadowing, and choroidal depression in some cases. Conclusion: B-ultrasound can be used to identify these two diseases. For some cases that are difficult to be diagnosed, follow-up examination can confirm the diagnosis.