目的：评估光学相干断层扫描血管成像（optical coherence tomography angiography，OCTA）在糖尿病性黄斑水肿（diabetic macular edema，DME）患眼的黄斑区微血管改变及其与视功能的相关性。方法：采用横断面研究，纳入临床检查确诊的无糖尿病性黄斑水肿的糖尿病性视网膜病变（diabetic retinopathy，DR）患者23例24只眼（明确无DME组）及曾经罹患过黄斑水肿但经抗血管内皮生长因子（vascular endothelial growth factor，VEGF）治疗后水肿消退的DR患者 14 例 16 只眼（DME经抗VEGF水肿消退组）。受检者均行眼压（intraocular pressure，IOP）、收缩压/舒张压（systolic blood pressure/diastolic blood pressure，SBP/DBP）、黄斑中心凹敏感度（foveal sensitivity，FT）及OCTA技术测量黄斑区 3 mm×3 mm范围内中心凹无血管灌注区面积（foveal avascular zone，FAZ）、浅层毛细血管密度（superior vessel density，SVD）、深层毛细血管密度（deep vessel density，DVD）。采用Pearson分析FT与其年龄，眼灌注压（ocular perfusion pressure，OPP），平均动脉压（mean arterial pressure，MAP），FAZ，SVD，DVD之间的相关性。结果：两组受检眼性别、年龄、眼灌注压对比差异无统计学意义，FT，FAZ，SVD，DVD比较，差异亦无统计学意义（均P>0.05）。相关性检验结果显示：两组受检眼之间FT与SVD，DVD比较，差异无统计学意义（均P>0.05）；明确无DME组中，FT与FAZ之间呈中等程度负相关，差异有统计学意义（r=−0.554，P<0.01）；而DME经抗VEGF水肿消退组中，FT与FAZ比较，差异无统计学意义（P>0.05）。结论：与明确无DME组相比，DME经抗VEGF水肿消退组OCTA各参数差异无统计学意义，提示抗VEGF治疗DME具有安全性。此外，黄斑水肿对糖尿病性视网膜病变患者OCTA中FAZ与FT的相关性有影响。

Objective: To quantitatively evaluate the macular microvascular changes in optical coherence tomography （OCTA） in patients with diabetic macular edema （DME） and its relationship with visual function. Methods: Twenty-three patients （24 eyes） with diabetic retinopathy （DR） without diabetic macular edema and 14 patients with DR who had macular edema but regained edema after anti-VEGF treatment （the DME subsided group） into the study. All subjects underwent intraocular pressure （IOP）, systolic blood pressure/diastolic blood pressure （SBP/DBP）, foveal sensitivity （FT）, foveal avascular zone （FAZ）, superior vessel density（SVD）, and deep vessel density （DVD） in a 3 mm×3 mm OCTA scan of macular. Pearson was used to analyze the correlation between FT and age, ocular perfusion pressure （OPP）, mean arterial pressure （MAP）, FAZ, SVD, DVD. Results: There was no significant difference in sex, age and eye perfusion pressure between the two groups. There were no significant differences between FT, FAZ, SVD and DVD （all P>0.05）. Correlation test showed that there were no significant differences in FT, SVD and DVD between the two groups （all P>0.05）. In addition, there was a significant difference between FT and FAZ （P<0.01）. However, there was no significant difference between FT and FAZ in the DME subsided group （P>0.05）. Conclusion: There is no significant difference in OCTA parameters between two groups, indicating the safety of anti-vascular endothelial growth factor in treating DME. In addition, macular edema exerts an effect on the relationship between FAZ and FT by OCTA.

目的：评估白内障手术是否影响高度近视黄斑劈裂的进展，为高度近视黄斑劈裂合并白内障患者先行白内障手术改善视觉质量可行性提供依据。方法：选取2018年4月至2021年1月在上海市第十人民医院眼科确诊为高度近视黄斑劈裂患者共36例36眼纳入研究。根据是否行白内障手术分为实验组：男10例10眼，女8例8眼；对照组：男9例9眼，女9例9眼。比较两组初诊及1个月、3个月、6个月、12个月后黄斑中心区视网膜厚度(central subfield thickness，CST)、黄斑区视网膜容积(macular volume，MV)、视网膜平均厚度(average macular thickness，AMT)、最佳矫正视力(best corrected visual acuity，BCVA)、黄斑劈裂形态学进展率情况。结果：两组CST、MV、AMT时间和组别交互效应差异无统计学意义(F=0.825，P=0.370；F=1.266，P=0.268；F=0.612，P =0.657)，两组间差异无统计学意义(F =2.519，P =0.122；F =3.318，P =0.077；F =1.378，P=0.249)。两组BCVA时间和组别交互效应差异有统计学意义(P<0.001)；做简单效应分析实验组术后1、3、6及12个月BCVA较初诊差异均有统计学意义(均P<0.001)；两组1、3、6、12个月BCVA较初诊BCVA的增量差异均有统计学意义(均P<0.001)。两组黄斑劈裂形态进展率差异无统计学意义(P=1.0)。结论：白内障超声乳化吸除术在短期内不影响高度近视黄斑劈裂的进展，且可以提高高度近视黄斑劈裂合并白内障患者的视力。

Objective: To assess whether cataract surgery can affect the progression of myopic foveoschisis, so as to provide evidence for the feasibility of cataract surgery to improve visual quality in patients with myopia foveoschisis accompanied by cataract. Methods: A total of 36 patients (36 eyes) diagnosed with high myopia foveoschisis at the Department of Ophthalmology, Shanghai Tenth People’s Hospital from April 2018 to January 2021 were enrolled in the study. The patients were divided into an experimental group (10 males with 10 eyes, and 8 females with 8 eyes) and an observation group (9 males with 9 eyes, and 9 females with 9 eyes) according to whether cataract surgery was performed. The central subfield thickness (CST), macular volume (MV), average macular thickness (AMT), best corrected visual acuity (BCVA), and the progression rate of foveoschis morphology were compared between the two groups at the initial diagnosis and 1 month, 3 months, 6 months, and 12 months after the surgery. Results: In terms of CST, MV, and AMT in the central macular area, no significant difference was found between the two groups (F=2.519, P=0.122; F=3.318, P=0.077; F=1.378, P=0.249), and there was no significant difference in time and group interaction effects between the two groups (F=0.825, P=0.370; F=1.266, P=0.268; F=0.612, P=0.657). In terms of BCVA, there was significant difference in time and group interaction effects between the two groups (P<0.001). The simple effect analysis showed that, compared with initial diagnosis, the BCVA in the experimental group was statistically significant at 1, 3, 6 and 12 months after the surgery (all P<0.001). In addition, there was a significant difference in the increments of BCVA between the two groups at 1, 3, 6, and 12 months after the surgery when compared with the initial diagnosis (all P<0.001). However, there was no significant difference in the morphological progression between the two groups (P=1.0). Conclusion: Phacoemulsification will not affect the progression of myopic foveoschisis in a short period, and can improve the vision of patients with myopic foveoschisis accompanied by cataract.