Effects of blood pressure and blood glucose levels on foveal avascular zone area

To explore whether blood pressure and blood glucose levels affect the foveal avascular zone (FAZ) area, a key parameter of retinal microvasculature. This was a cross-sectional study in which 253 patients with essential hypertension and/or type 2 diabetes were consecutively enrolled from the Department of Geriatrics Health Care at our hospital between January 2023 and January 2024. The FAZ area was quantitatively measured using optical coherence tomography angiography (OCTA). A multivariable linear regression model was used to explore the relationship between blood pressure, blood glucose, and the FAZ area. The cohort was stratified into four groups based on quartile of FAZ area. The median systolic blood pressure (SBP) for each group was as follows: 121 mmHg, 126 mmHg, 126 mmHg, and 129 mmHg, with a significant intergroup difference (p = 0.046). Spearman correlation analysis revealed a significant positive association between mean SBP and FAZ area (r = 0.151, p < 0.05). Univariable analysis indicated that gender and hemoglobin (HGB) levels were also associated with the FAZ area. Following adjustment for gender and HGB in the linear regression model, mean SBP remained markedly associated with FAZ area (β = 0.0008, p = 0.037). Mean SBP may serve as a potential risk factor for alterations in the FAZ area. Control of mean SBP holds clinical importance for the prevention of retinal microvascular pathology.