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目的:观察视网膜静脉阻塞（RVO）伴黄斑水肿（ME）患者玻璃体腔注射阿柏西普（IVA）治疗后黄斑区微血管变化，初步分析其与最佳矫正视力（BCVA）的相关性。方法:回顾性临床研究。2019年4月至2020年2月于天津市眼科医院临床检查确诊的单眼RVO伴ME （RVO-ME）患者30例30只眼纳入研究。其中，男性12例12只眼，女性18例18只眼；平均年龄（54.30±13.17）岁；平均病程（3.43±1.97）个月。双眼均行BCVA、光相干断层扫描血管成像（OCTA）检查。IVA治疗方案采用首次注射后按需注射。采用OCTA仪对双眼黄斑区6 mm×6 mm范围进行扫描，测量基线时及治疗后1、3、6个月黄斑中心凹无血管区（FAZ ）面积、FAZ周长（PERIM ）、非圆度指数（AI）、FAZ范围300 μm宽度内的血流密度（FD-300 ）、黄斑中心凹视网膜厚度（CMT）以及视网膜浅层毛细血管丛（SCP）、视网膜深层毛细血管丛（DCP）血流密度。基线时患眼与对侧健康眼各定量参数比较釆用配对n t检验；基线时及治疗后1、3、6个月各定量参数变化采用重复测量方差分析。IVA治疗后6个月BCVA与视网膜灌注、黄斑区血液供应参数的相关性分析采用Pearson相关分析。n 结果:基线时，与对侧健康眼比较，RVO-ME患眼FAZ面积（n t=-4.091）、PERIM （n t=-5.098）、AI （n t=-9.093）扩大，FD-300 （n t=7.237）及整体SCP、DCP血流密度（n t=8.735、9.897）降低，差异均有统计学意义（n P<0.001 ）。治疗后6个月，RVO-ME患眼BCVA明显提高，CMT降低，FAZ面积扩大，AI降低（n t=8.566、16.739、-6.469、9.719，n P0.05 ）。与基线时比较，治疗后3、6个月RVO-ME患眼FAZ面积逐渐扩大，差异有统计学意义（n F=21.979，n P<0.001 ）。相关性分析结果显示，治疗后6个月BCVA与基线时、治疗后6个月整体SCP、DCP血流密度呈正相关（n r=-0.538、-0.484、-0.879、-0.854 ，n P<0.05 ），与治疗后6个月FAZ面积呈负相关（n r=0.544 ，n P=0.001）。ME复发次数与治疗后6个月BCVA和整体SCP、DCP血流密度呈负相关（n r=0.604、-0.462、-0.528，n P<0.05 ），与FAZ面积呈正相关（n r=0.379，n P= 0.043 ）。n 结论:RVO-ME患眼IVA治疗6个月内ME显著减轻，视力提高；SCP血流密度下降，FAZ面积扩大。“,”Objective:To observe the changes of macular microvessels in patients with retinal vein occlusion (RVO) and macular edema (ME) after intravitreal injection of aflibercept (IVA), and analyze its correlation with best corrected visual acuity (BCVA).Methods:A retrospective case study. Thirty patients (30 eyes) with monocular RVO with ME (RVO-ME) who were diagnosed in the clinical examination of Tianjin Eye Hospital from April 2019 to February 2020 were included in the study. Among them, there were 12 males (12 eyes) and 18 females(18 eyes); the average age was 54.30±13.17 years. The average course of disease was3.43±1.97 months. Both eyes were examined by BCVA and optical coherence tomography (OCTA). The on-demand injection was adopted after the first injection in IVA treatment regimen. The macular area 6 mm×6 mm in both eyes was scanned with an OCTA instrument, and the area of the foveal avascular area (FAZ), FAZ circumference (PERIM), and out-of-roundness were measured at baseline and 1, 3, and 6 months after treatment. Index (AI), blood flow density within 300 μm width of FAZ (FD-300), foveal retinal thickness (CMT), superficial retinal capillary plexus (SCP), deep retinal capillary plexus (DCP) blood flow density. The paired n t test was used to compare the quantitative parameters of the affected eye and the contralateral healthy eye at baseline; the changes of the quantitative parameters at baseline and 1, 3, and 6 months after treatment were analyzed by repeated measures analysis of variance. Pearson correlation analysis was used to analyze the correlation between BCVA, retinal perfusion, and macular blood supply parameters at 6 months after IVA treatment.n Results:At baseline, compared with the contralateral healthy eye, the FAZ area (n t=-4.091), PERIM (n t=-5.098) and AI (n t=-9.093) of the RVO-ME eye were enlarged, and FD-300 (n t=7.237) and overall SCP and DCP blood flow density (n t=8.735, 9.897) decreased, the difference was statistically significant (n P<0.001). Six months after treatment, the BCVA of RVO-ME eyes was significantly increased, CMT decreased, FAZ area expanded, and AI decreased (n t=8.566, 16.739, -6.469, 9.719; n P0.05). Compared with baseline, the FAZ area of RVO-ME eyes gradually expanded at 3 and 6 months after treatment, and the difference was statistically significant (n F=21.979, n P<0.001). Correlation analysis results showed that BCVA at 6 months after treatment was positively correlated with the overall SCP and DCP blood flow density at baseline and 6 months after treatment (n r=-0.538, -0.484, -0.879, -0.854; n P<0.05). There was a negative correlation with the area of FAZ 6 months after treatment (n r=0.544, n P=0.001). The number of ME recurrences was negatively correlated with BCVA and overall SCP and DCP blood flow density 6 months after treatment (n r=0.604, -0.462, -0.528; n P<0.05), it was positively correlated with FAZ area (n r=0.379, n P=0.043).n Conclusion:Within 6 months of IVA treatment in RVO-ME eyes, ME is significantly reduced and visual acuity is improved; SCP blood flow density decreases, and FAZ area expands.