目的:研究视野半侧缺损的原发性开角型青光眼（POAG）视盘旁和黄斑区血管密度的改变及其与视网膜神经纤维层（RNFL）厚度及视野指标的关系。方法:横断面研究。收集2015年10月至2018年10月于复旦大学附属眼耳鼻喉科医院眼科应用Humphery视野计30-2程序检测为视野半侧缺损的POAG患者（POAG组）28例（28只眼），同期纳入性别、年龄匹配的健康志愿者（健康对照组）31名（31只眼）。所有受试者均接受了全面的眼科检查，包括RNFL、视网膜神经节细胞复合体（GCC）厚度及视野检查等，并收集了一般信息。采用相干光层析血管成像术检测视盘旁放射状盘周毛细血管（RPC）和黄斑区视网膜浅层毛细血管丛（SCP）的血管密度。健康对照组与POAG组、健康对照组与POAG组视野正常半侧检测结果比较采用独立样本秩和检验，POAG组内视野缺损半侧与视野正常半侧检测结果比较采用配对秩和检验。结果:POAG组男性16例，女性12例，年龄（47±12）岁；POAG组与健康对照组性别分布、年龄、眼压、中央角膜厚度、眼轴长度和眼内灌注压差异均无统计学意义（均n P>0.05）。POAG组上、下半侧视野缺损者分别有19、9例。POAG组视盘旁RPC和黄斑区SCP血管密度分别为45.86%（34.92%~52.78%）、39.31%（32.55%~46.79%），均低于健康对照组［56.90%（51.69%~60.84%）、47.48%（37.95%~52.25%）］，差异均有统计学意义（n Z=-6.56，-5.86；均n P0.05). Among POAG patients, there were 19 cases with upper and 9 cases with lower visual field defect. In the POAG eyes, the vascular density of peripapillary RPC and macular SCP were 45.86% (34.92%-52.78%) and 39.31% (32.55%-46.79%), respectively. In the normal eyes, the vascular density of peripapillary RPC and macular SCP were 56.90% (51.69%-60.84%) and 47.48% (37.95%-52.25%), respectively. The difference was statistically significant (n Z=-6.56, -5.86; both n P<0.01). The RNFL and GCC thicknesses in the POAG group were 84.4 (62.1-97.1), 76.4 (60.3-92.5) μ m, respectively, which were smaller than those in normal controls [110.6 (95.7-131.6), 98.1 (84.0-109.2) μm;n Z=-6.57, -6.36; both n P<0.01]. In the POAG eyes, the peripapillary RPC [44.12% (34.73%-53.20%)n vs. 51.85% (38.64%-61.02%); n Z=-4.62; n P<0.01] and macular SCP [36.81% (29.73%-47.82%)n vs. 41.78% (33.93%-49.22%);n Z=-4.12; n P<0.01] vessel densities were reduced in the abnormal hemisphere compared with the opposite hemisphere. Compared with the normal eyes, the normal hemisphere of the POAG eyes had lower peripapillary RPC and macular SCP vessel densities (n Z=-5.08, -4.95; both n P<0.01), a thinner RNFL and a thinner retinal GCC [93.0 (61.9-116.5) μmn vs. 110.6 (95.7-131.6) μm, n Z=-5.15; 86.3 (67.2-98.2) μm n vs. 98.1 (84.0-109.2) μm, n Z=-5.35; bothn P0.05).n Conclusions:The retinal vessel density reduce in eyes with POAG with single-hemifield VF defects. The normal hemisphere of POAG eyes have a reduced retinal microcirculation along with the thinning of the RNFL and GCC, suggesting that vascular dysfunction and structural changes preceded VF loss in POAG. n (Chin J Ophthalmol, 2021, 57: 201-206)