Objective: To observe changes in foveal avascular zone(FAZ) and capillary plexus in idiopathic macular epiretinal membrane (IMEM) in optical coherence tomography angiography (OCTA) and analyze their correlation with the visual acuity. Methods: Cross-sectional study. 42 patients (15 Males and 27 females, age 64.8) from the Eye Hospital of Wenzhou Medical University were included with 51 eyes diagnosed as IMEM (IMEM group), and 23 normal eyes (9 Males and 14 females, control group). All patients received the examination of fissure lamp combined with fundus pre-set lens, best corrected visual acuity (BCVA), OCT angiography (OCTA) and fundus photo. OCTA was performed on 3 mm× 3 mm sections centred on the fovea. The software automatically measured the superficial capillary plexus (SCP) and deep capillary plexus (DCP) vessel density(VD) and retinal thickness(RT) and FAZ area. The IMEM eyes were compared with the normal eyes and correlation between the parameters of OCTA and BCVA was analyzed in IMEM. Independent-sample t test and MannWhitney test were used for comparison between groups, and Spearman test was used for correlation analysis. Results: LogMAR BCVA in the IMEM group was 0.40(0.15, 0.70), in the control group was 0.10(0.05, 0.22). FAZ area of IMEM group was (0.09±0.05) mm(2), while that of control group was (0.34±0.13)mm(2).Compared with the control group, in IMEM group, the BCVA was worse (Z=-4.443, P<0.001), FAZ area was smaller (t=-9.198, P<0.001), RT was increased (P<0.001), The foveal DCP and SCP vessel density was increased (t=4.280, 9.079, P<0.01), The parafoveal DCP vessel density was decreased (P<0.05), The parafoveal SCP vessel density was decreased in superior, inferior and nasal side (t=-2.759, Z=-3.998, Z=-2.108; P<0.05). The BCVA was negatively correlated with FAZ area (r=-0.337, P=0.017), positively correlated with center macular thickness (r=0.324, P=0.020). The BCVA was no correlated with foveal VD and parafoveal DCP vessel density (P>0.05), but correlated with SCP vessel density(P<0.05). Conclusions: In the IMEM eyes the BCVA was worse, FAZ area was smaller, foveal vessel density was increased and the parafoveal vessel density was decreased compared with the normal eyes. The smaller the FAZ area, the smaller foveal SCP vessel density, the poorer BCVA. There was no correlation between BCVA and DCP vessel density. Changes in VD in IMEM eyes may lead to changes in vision. (Chin J Ophthalmol, 2019, 55:757-762).目的: 探讨特发性黄斑前膜(IMEM)相干光层析血管成像术(OCTA)检查黄斑中心凹无血管区(FAZ)面积及毛细血管丛血流密度的改变及其与视力的相关性。 方法: 横断面研究。收集2016年1月至2017年12月在温州医科大学附属眼视光医院杭州院区确诊为IMEM的患者42例(51只眼)作为IMEM组,其中男性15例,女性27例,年龄(64.8±7.7)岁。另从这42例患者中选取23只健康眼作为对照组。所有患者均行裂隙灯显微镜联合前置镜、最佳矫正视力(BCVA)、OCTA及眼底照片检查。采用OCTA自带软件进行3 mm×3mm图片中FAZ面积、中心凹以及中心凹旁各方位(上方、下方、鼻侧、颞侧)的深层及浅层毛细血管丛血流密度、视网膜厚度的测量。将IMEM眼与黄斑前膜患者对侧健眼进行比较。并分析IMEM眼中OCTA这些参数改变与BCVA的相关性。组间比较采用独立样本t检验及MannWhitney检验,相关性分析采用Spearman相关系数研究。 结果: IMEM组LogMAR BCVA为0.40(0.15,0.70),对照组LogMAR BCVA为0.10(0.05,0.22)。IMEM组FAZ面积为(0.09±0.05)mm(2),对照组FAZ面积(0.34±0.13)mm(2)。IMEM组较对照组,BCVA差(Z=-4.443,P<0.001)、FAZ面积缩小(t=-9.198,P<0.001)、中心凹以及中心凹旁视网膜厚度均增加(P<0.001)。IMEM组深层及浅层中心凹血流密度增加(t=4.280、9.079,P<0.01);中心凹旁血流密度,深层上、下、鼻、颞均较对照组减小(P<0.05);浅层上、下、鼻侧较对照组减小(t=−2.759,Z=−3.3358,Z=−2.108,P<0.05),颞侧(t=−1.632,P=0.107)差异无统计学意义。BCVA与FAZ面积呈负相关(r=-0.337,P=0.017),与黄斑中心凹厚度呈正相关(r=0.324,P=0.020)。BCVA与中心凹血流密度无相关性(P>0.05),与深层毛细血管丛血流密度无相关性(P>0.05),而与浅层中心凹旁毛细血管丛血流密度有相关性(P<0.05)。 结论: OCTA可见IMEM眼较健康眼FAZ面积缩小,毛细血管丛中心凹血流密度增加,中心凹旁血流密度减少。FAZ越小,中心凹旁浅层血流密度越小,视力越差。而视力与深层血流密度无相关性。IMEM黄斑区的血流改变可能会导致视力的改变。(中华眼科杂志,2019,55:757-762).

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