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目的 分析特发性黄斑前膜(IMEM)玻璃体切除术后黄斑区视网膜微血管的变化.方法 回顾性病例研究.收集天津市眼科医院2015年5月至2017年7月经光学相干断层扫描血管成像技术(OCTA)确诊的IMEM连续病例33例(33眼)的临床资料.患者均接受玻璃体切除联合内界膜剥除术.术后随访观察12个月.结果 术后BCVA(LogMAR)由0.700±0.309提高至0.252±0.182(t=7.212,P=0.000);黄斑中心区厚度(CMT)由(447.44±96.96) μm降至(373.56±82.36) μm(t=8.247,P=0.000);黄斑中心区无血管面积(FAZ)由(0.120±0.059) mm2增加至(0.145±0.063) mm2(t=6.660,P=0.000).以OCTA检查浅层和深层黄斑区血管密度(MVD)明显增加(P＜0.05).相关性分析BCVA与CMT呈负相关(r=-0.507,P=0.014),与深层MVD呈正相关(r=0.578,P=0.024).结论 通过OCTA定量检测黄斑区微血管变化,IMEM患者玻璃体切除术后FAZ、MVD均增加.“,”Objective To analyze the changes of macular capillaries in patients with idiopathic macular epiretinal membrane (IMEM) after vitrectomy.Methods A retrospective study.The clinical data of 33 eyes of 33 cases with IMEM after vitrectomy and internal limiting membrane peeling from May 2015 to Jul.2017 in Tianjin Eye Hospital were collected.All patients were diagnosed with optical coherence tomography angiography (OCTA) and followed-up for 12 months.Results The BCVA (logMAR) after surgery was improved from 0.700±0.309 to 0.252±0.182 (t =7.212,P =0.000),while central macular thickness (CMT) was decreased from (447.44±96.96) μm to (373.56±82.36) μm after surgery (t =8.247,P=0.000),and foveal avascular zone (FAZ) was increased from (0.120±0.059)mm2 to (0.145±0.063)mm2(t =6.660,P =0.000).The macular vascular density (MVD) in the superficial and deep macular area examined with OCTA were increased significantly (P＜0.05).There was a negative correlation between BCVA and CMT (r=-0.507,P=0.014),while a positive correlation between BCVA and deep MVD (r =0.578,P =0.024).Conclusion Microvascular changes in macular area are quantitatively detected with OCTA,and FAZ and MVD increase in patients after IMEM vitrectomy.