An Optical Coherence Tomography Angiography Study of the Relationship Between Foveal Avascular Zone Size and Retinal Vessel Density

PURPOSE. To assess the relationship between the size of the foveal avascular zone (FAZ; area and perimeter) and vessel density (VD) at various retinal regions using optical coherence tomography angiography (OCTA) in patients with open-angle glaucoma (OAG). METHODS. In this retrospective cross-sectional study, OAG eyes were grouped according to the presence/absence of central visual field (CVF) defects. A control group of normal eyes was also included. OCTA images were obtained from the optic nerve (4.5 x 4.5 mm(2)) and macular (3 x 3 mm(2)) area, in which VDs were measured in the circumpapilla, parafovea, and fovea regions. Partial correlation analyses between FAZ parameters representing size and VDs at different retinal regions were performed. The correlation between FAZ parameters and macular ganglion cell-inner plexiform layer thickness (mGCIPLT) and CVF mean sensitivity (MS) was also assessed. For spatial correspondence, correlations between FAZ parameters and corresponding VD, mGCIPLT, and CVF-MS measurements were assessed at each hemiretina. RESULTS. A total of 126 OAG eyes and 40 controls were reviewed. Overall, FAZ parameters showed statistically significant correlations with VDs measured at the fovea, parafovea, and circumpapilla (FAZ area: r = -0.603, -0.385, -0.256; P < 0.001, < 0.001, and 0.003, respectively). These correlations were observed regardless of the presence of CVF defects (all P < 0.05). FAZ size showed significant spatial correlations with VD, mGCIPLT, and CVF-MS measurements at each hemiretina. CONCLUSIONS. OCTA-derived FAZ area and perimeter showed statistically significant correlations with VDs measured at various retinal locations with spatial correspondence in OAG.