目的:探讨光学相干断层扫描血管成像(OCTA)在观察特发性黄斑前膜(IMEM)患者手术前后黄斑中心区厚度(CMT)和视网膜血流变化情况中的应用价值。方法:回顾性研究。纳入2019年2月—2020年2月蚌埠医学院第一附属医院眼科收治的IMEM患者21例(21眼)，其中男10例、女11例，年龄42～83岁。所有患者行25 G玻璃体切除联合黄斑前膜剥离术。术前及术后3个月行视力测量和OCTA检查，比较患者手术前后最佳矫正视力(BCVA)、CMT、黄斑中心凹无血管区(FAZ)面积、视网膜浅层毛细血管密度(SVD)、视网膜深层毛细血管密度(DVD)以及黄斑区形态结构的变化。结果:21例患者均顺利完成手术，手术时间40～65 min，平均50 min。术后有3例患者出现高眼压、1例患者出现前房炎症反应，予相应处理后痊愈。21例患者术后均随访3个月，术后3个月患者最佳矫正视力0.61±0.26，较术前的0.82±0.32明显提高，差异有统计学意义(n t＝2.588, n P<0.05)。术后3个月OCTA检查结果显示，CMT为(287.05±64.79) μm，较术前的(469.33±101.88) μm明显减小，FAZ面积(0.19±0.12) mmn 2、SVD 52.50%±12.62%，较术前的(0.13±0.10) mmn 2、48.58%±11.96%均增大，差异均有统计学意义(n t＝7.050、2.330、4.358, n P值均0.05)；患者术后3个月黄斑中心凹形态基本恢复，黄斑水肿减轻。n 结论:OCTA为无创的新型血管成像技术，应用OCTA可很好地观察IMEM患者术后黄斑区的结构和血流变化情况，可为玻璃体切除联合黄斑前膜剥除术后手术效果的评定提供影像学依据。“,”Objective:This study aims to explore the application value of the optical coherence tomography (OCTA) in observing the changes in the central macular thickness (CMT) and the retinal blood flow in patients with idiopathic macular epiretinal membrane (IMEM) before and after surgery.Methods:A total of 21 patients with IMEM (21 eyes; 10 males and 11 females aged 42-83 years) admitted to the Department of Ophthalmology, the First Affiliated Hospital of Bengbu Medical College from February 2019 to February 2020 were retrospectively researched. All patients underwent the 25G vitrectomy combined with the epidermal macular dissection. The visual acuity measurement and the OCTA examination were performed three months after surgery. The best corrected visual acuity(BCVA), CMT, foveal avascular area (FAZ) , vessel density of superficial capillary plexus (SVD), vessel density of deep capillary plexus (DVD), and changes in the morphological structure of the macula were compared before and after surgery.Results:All 21 patients successfully completed the operation. The operation time was 40-65 minutes (average=50 minutes). After the operation, three patients developed the high intraocular pressure, and one patient developed the anterior chamber inflammation, which was cured after corresponding treatment. The 21 patients were followed up for three months after the operation. The best corrected visual acuity (0.61±0.26) of the patients was significantly improved three months after the operation (0.82±0.32; n t=2.588, n P<0.05). The results of the OCTA examination three months after the operation showed that the CMT ([287.05±64.79] μm) was significantly lower than before the operation ([469.33±101.88] μm), and the difference was statistically significant(n t=7.050, n P<0.05). The postoperative FAZ area (0.19±0.12) mmn 2 and the SVD (52.50%±12.62%) were significantly increased compared with the preoperative FAZ area (0.13±0.10) mmn 2 and the SVD (48.58%±11.96%), and the differences were statistically significant(n t=2.330, 4.358, all n P values0.05). The shape of the fovea basically recovered, and the macular edema was reduced after three months.n Conclusions:The OCTA is a new noninvasive vascular imaging technology. The application of OCTA can observe the structure and the blood flow changes in the macular area of patients with IMEM after surgery and provide imaging evidence for the evaluation of the surgical effects after the vitrectomy combined with the macular peeling.