目的：利用自适应光学扫描激光检眼镜(AOSLO)技术分析年龄相关性黄斑变性(ARMD)患者黄斑区视锥细胞形态与结构变化，评估其在ARMD中的应用价值。

方法：回顾性横断面研究。选取2025年9月至2025年10月在陆军军医大学陆军特色医学中心眼科就诊并进行了AOSLO检查的ARMD患者作为试验组(ARMD组)，将匹配年龄段进行AOSLO检查且仅存在年龄相关性白内障或白内障术后人工晶状体状态的人群作为对照组(CON组)。使用AOSLO设备分析黄斑中心区域2.4°×2.4°范围内视锥细胞密度(PCPD)、平均细胞间距、细胞离散度及细胞规则度。

结果：本研究最终纳入参与者53例66眼，其中ARMD组24例33眼\〖中期ARMD组6例6眼，晚期ARMD组22例27眼(其中4例患者1眼入中期ARMD组，另1眼入晚期ARMD组)\〗，对照组29例33眼。ARMD组年龄69.36±9.79岁，男13例，女11例。对照组年龄64.64±10.31岁，男17例，女12例。与对照组相比，ARMD组的PCPD(31635±4887 vs 38524±3578 cells/mm²，P<0.01)和细胞规则度(95.16%±0.75% vs 96.07%±0.67%，P<0.01)降低，而平均细胞间距(4.43±0.26 vs 4.22±0.23 μm，P<0.01)和细胞离散度(20.23%±2.72% vs 16.47%±1.85%，P<0.01)增大，且晚期ARMD组PCPD(30831±4826 cells/mm²)较中期ARMD组(35254±3534 cells/mm²)减少更加显著(P<0.05)。

结论：AOSLO检查中ARMD患者光感受器细胞病变表现为PCPD、细胞规则度降低，而细胞间距、离散度增大，ARMD患者视功能受损与光感受器细胞病变密切相关，AOSLO作为无创可定量的检查在ARMD临床诊断中具有良好的应用前景。

METHODS:This was a retrospective cross-sectional study. Patients with ARMD who visited the Department of Ophthalmology, Army Medical Center of PLA, Army Medical University, and underwent AOSLO examination between September 2025 and October 2025 were enrolled as the experimental group(ARMD group). Age-matched individuals who underwent AOSLO examination during the same period and had either age-related cataract or pseudophakia with a normal macular region were selected as the control group(CON group). The AOSLO device was used to image a 2.4°×2.4° area of the fovea, and parameters including parafoveal cone photoreceptor density(PCPD), average inter-cell spacing, cell dispersion, and cell regularity were analyzed.

RESULTS:A total of 53 participants(66 eyes)were included, comprising 24 patients(33 eyes)in the ARMD group \〖comprising 6 participants(6 eyes)in the intermediate ARMD group and 22 participants(27 eyes)in the late ARMD group(4 participants had one eye in the intermediate group and the other in the late ARMD group)\〗, and 29 participants(33 eyes)in the CON group. The ARMD group included 13 males and 11 females, with a mean age of 69.36±9.79 y. The control group included 17 males and 12 females, with a mean age of 64.64±10.31 y. Compared to the CON group, the ARMD group exhibited significantly lower PCPD(31635±4887 vs 38524±3578 cells/mm², P<0.01)and cell regularity(95.16%±0.75% vs 96.07%±0.67%, P<0.01), along with significantly greater average inter-cell spacing(4.43±0.26 vs 4.22±0.23 μm, P<0.01)and cell dispersion(20.23%±2.72% vs 16.47%±1.85%, P<0.01). Subgroup analysis within the ARMD group revealed that PCPD was significantly lower in the late ARMD subgroup(30831±4826 cells/mm²)compared to the intermediate ARMD subgroup(35254±3534 cells/mm², P<0.05).

CONCLUSION:Photoreceptor pathology in ARMD patients, as assessed by AOSLO, is characterized by decreased PCPD and cell regularity, as well as increased inter-cell spacing and dispersion. These structural alterations are closely associated with photoreceptor cell lesions. AOSLO, as a non-invasive and quantitative imaging modality, demonstrates promising application prospects in the clinical diagnosis of ARMD.