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Purpose To evaluate changes that occur in foveal avascular zone (FAZ) in diabetic hypertensive patients by optical coherence tomography angiography (OCTA). Patients and methods OCTA was performed for 60 eyes of 35 diabetic hypertensive patients. This study was done in Benha University Hospital between February and June 2021. FAZ area was measured by a frame that was centered around it. Moreover, the vessel density was measured also by detecting the superficial vessel density (SVD) and the deep vessel density (DVD). Results In diabetic hypertensive (60 eyes of 35 patients) with average age 55.52 (±6.88) years and mean duration of the disease 12.17 (±7.15) years, the mean value of the FAZ was 0.37 (±0.54) mm, denoting enlargement of the FAZ diameter. In addition, the vessel density showed that there is decreasing in the SVD (43.9±5.89) and it was correlated to the best-corrected visual acuity and age of the patients (P<0.05), while it was highly correlated to the DVD (P<0.001). On the other hand, there was a decrease in DVD with a mean of 43.17±7.44, which was statistically significant with the age of the patients (P<0.05), but there was no significant relationship with duration of the disease, glycated hemoglobin, and best-corrected visual acuity. Conclusion OCTA is a noninvasive technique to image the retinal and choroidal vasculature. The study concluded that diabetic retinopathy in the presence of systemic hypertension leads to increasing of the FAZ area. Moreover, it leads to decreasing in both the SVD and DVD. Also, it allows for early detection and easy follow-up of the disease.

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