目的：分析视网膜前巨噬细胞样细胞（epiretinal macrophage-like cells，eMLC）和视网膜脉络膜血流在急性黄斑神经视网膜病变（acute macular neuroretinopathy，AMN）患眼的临床特征。方法：回顾性分析2022年12月—2023年5月在中山大学中山眼科中心就诊的病程2周内的AMN患者21例（37眼）及年龄匹配的健康对照组33例（38眼）的临床资料。通过黄斑区内界膜上3 μm的en face 光学相干断层扫描（optical coherence tomography，OCT）分层信息对eMLC进行半自动分析提取和定量，同时测量OCT血管成像（optical coherence tomography angiography，OCTA）6 mm² x 6 mm²的黄斑区域内视网膜脉络膜血流参数进行分析对比。结果： AMN组黄斑区eMLC数量为（329.78±77.38）个，密度为（9.16±2.15）个/mm²，均较对照组（202.63±41.72）个、（5.63±1.16个/mm²）增加（均P＜0.001）。AMN组浅层和深层视网膜血流密度分别为（33.00±6.49）（32.59±7.41）%，均较对照组（36.18±5.63）（37.08±5.65）%减少（均P＜0.05）。视网膜全层中心凹无血管区（foveal avascular zone，FAZ）面积、视网膜全层血流密度、脉络膜毛细血管和脉络膜大中血管血流密度在两组间比较差异无统计学意义（P＞0.05）。浅层及深层视网膜血流密度和FAZ面积对eMLC密度无影响（P＞0.05）。13例AMN患者（23眼）1个月时的随访资料显示：AMN组末次随访时eMLC数量为（248.70±59.88）个、密度为（6.91±1.66）个/mm²较初次就诊时（307.87±82.98）个和（8.55±2.30）个/mm²减少（均P＜0.001），但仍高于同期对照组（176.58±27.89）个和（4.91±0.77）个/mm²（均P＜0.001）。视网膜和脉络膜血流参数较初次就诊时比较差异无统计学意义（均P＞0.05）。结论：AMN患眼中eMLC异常增多和聚集，同时存在轻度的视网膜血流密度下降，但无脉络膜血流参数变化，且eMLC变化与AMN病程相关但与视网膜血流变化无关，提示eMLC所代表的炎症可能独立参与了AMN的发生。

Objective: To investigate the clinical characteristics of epiretinal macrophage-like cells (eMLC) and retinochoroidal blood flow in eyes affected by acute macular neuroretinopathy (AMN). Methods: This retrospective case series study included 21 (37 eyes) patients diagnosed with AMN and 28 (33 eyes) healthy age-matched subjects. A 3 mm En-face optical coherence tomography (OCT) slab on the inner limiting membrane of the macular region was used to visualize and binarize the MLCs. The MLCs were binarized and quantified using a semiautomated method. Optical coherence tomography angiography (OCTA) was used to evaluate the perfusion status and obtain the structural data of macular within a 6 x 6 mm² macular region. Results: The number and density of macular eMLC in AMN eyes were significantly increased in comparison to control eyes: 329.78±77.38 vs. 202.63±41.72, (P＜0.001) and (9.16±2.15) cells/mm² vs. (5.63±1.16) cells/mm² (P＜0.001). In the macular region, both superficial and deep retinal vessel densities were significantly lower in the AMN eyes than in the control eyes: 33.00±6.49 vs. 36.18±5.63 (P=0.040); 32.59±7.41 vs. 37.08±5.65 (P=0.008). There were no significant differences in the vessel densities and foveal avascular zone (FAZ) area of full retina and choroidal vessel density between the two groups (P＞0.05). The eMLC density was not associated with the superficial and deep retinal FAZ area and vessel densities (all P＞0.05). At the one-month follow-up data of 13 patients (23 eyes), the number and density of macular eMLC were significantly lower in comparison to the initial visit: 248.70±59.88 vs. 307.87±82.98, P＜0.001 and (6.91±1.66) cells/mm² vs. (8.55±2.30) cells/mm² (P＜0.001). However, the number and density of macular eMLC are still noticeably higher than those of the control group during the same timeframe: 248.70±59.88 vs. 176.58±27.89 (P＜0.001) and (6.91±1.66) cells/mm² vs. (4.91±0.77) cells/mm² (P＜0.001). There was no significant difference in the vessel density of retina and choroidal during the follow-up (P＞0.05). Conclusions: The aggregation and activation of eMLC and a mild decrease in retinal blood flow density are observed in AMN, yet there is no corresponding shift in choroidal vessel density. The changes of eMLC are linked to the course of AMN, but they are not related to retinal vessel density. The inflammatory response represented by eMLC might independently contribute to the pathogenesis and progression of AMN.