方法：横断面研究。收集2019-01/2021-04于福州东南眼科医院青光眼科门诊就诊患者，早期POAG组45例70眼，其中男32例49眼，女13例21眼，年龄48.50(26.75，64.50)岁，高眼压症组37例65眼，其中男17例29眼，女20例36眼，年龄37.00(27.00，47.00)岁，健康组51例94眼，其中男23例39眼，女28例55眼，年龄46.00(34.50，56.50)岁。分别对三组进行常规的眼科检查包括最佳矫正视力(BCVA)、眼压、视野、视网膜神经纤维层厚度(RNFL)、中央角膜厚度(CCT)等，通过光相干断层扫描血管成像检查(OCTA)采集并测量三组的视盘中心区、内层区、外层区和完整区的视盘血流密度。

结果：三组眼压比较有差异(H=146.876，P<0.001)，早期POAG组和高眼压症组与健康组的眼压值有差异(均P<0.01)，早期POAG组和高眼压症组患者的眼压无差异(P=0.132)。早期POAG组和高眼压症组的BCVA、RNFL、MD值比较有差异(P=0.005、0.01、<0.01)，早期POAG组和健康组两者的BCVA、RNFL、MD值比较有差异(P=0.013、<0.01、<0.01)，高眼压症组和健康组两者的BCVA、RNFL、MD值比较无差异(P=1.000、0.660、1.000)。早期POAG组和健康组之间CCT无差异(P=0.074)，早期POAG组和高眼压症组之间CCT比较有差异(P=0.006)，高眼压症组和健康组之间CCT比较有差异(P<0.01)在中心区、内层区、完整区，早期POAG组和高眼压症组的血流密度比较有差异(均P<0.01)，早期POAG组和健康组的血流密度比较有差异(均P<0.01)，高眼压症组和健康组比较无差异(均P=1.000)。在外层区，早期POAG组和健康组的血流密度比较有差异(P=0.001)，高眼压症组和早期POAG组及健康组比较有差异(P=0.067、0.877)。

结论：早期POAG的视盘血流密度相比高眼压症和健康者是减少的，与视野MD、RNFL参数的变化是相一致的，早期POAG视盘不同区域血流密度均减少。

METHODS: A cross-sectional study. From January 2019 to April 2021, patients were selected in the Department of Glaucoma in Fuzhou Southeast Eye Hospital. There were 45 patients(70 eyes)of early POAG group, including 32 males(49 eyes)and 13 females(21 eyes)with age of 48.50(26.75, 64.50)years. There were 37 patients(65 eyes)of ocular high tension group, including 17 males(29 eyes)and 20 females(36 eyes)with age of 37.00(27.00, 47.00)years. There were 51 patients(94 eyes)of healthy group, including 23 males(39 eyes)and 28 females(55 eyes)with age of 46.00(34.50, 56.50)years. Ophthalmic examinations including best-corrected visual acuity(BCVA), intraocular pressure, central corneal thickness(CCT), mean deviations(MD), retinal nerve fiber layers thickness(RNFL)were measured in three groups. The center area, the inner circle area, the outer circle area, and the whole area of the optic vessel density in three groups were measured via optical coherence tomography angiography(OCTA)device.

RESULTS: The difference of the intraocular pressure in early POAG group-ocular high tension group was not significant(H=146.876,P<0.001), while significantly in early POAG group-healthy group and ocular high tension group-healthy group(all P<0.01). Significant differences in BCVA, MD, and RNFL were observed in early POAG group-ocular high tension group(P=0.005, P=0.01, P<0.01)and early POAG group-healthy group(P=0.013, P<0.01, P<0.01), while the difference was not found in ocular high tension group-healthy group(P=1.000, P=0.660, P=1.000). There was no difference of CCT in early POAG group-healthy group(P=0.074), and significant differences were observed in early POAG group-ocular high tension group and ocular high tension group-healthy group(P=0.006, P<0.01). The optic vessel density comparison in the center area, the inner circle area, and the whole area were significantly different in early POAG group-ocular high tension group(all P<0.01)and in early POAG group-healthy group(all P<0.01), which indicated that the optic vessel density was obviously less in the early POAG group than the other two groups. The optic vessel density had no significant difference in ocular high tension group-healthy group in these areas(all P=1.000). In the outer circle area, there were no significant differences of the optic vessel density in early POAG group-ocular high tension group and early POAG group-healthy group(P=0.067, P=0.877), while significant difference was observed in early POAG group-healthy group(P=0.001).

CONCLUSION: The optic vessel density was decreased in early POAG comparing with ocular high tension subjects and healthy subjects, which was agree with the changes of MD, RNFL. The optic vessel density decreased firstly from the center area and the inner circle area for early POAG.