Relationship Between Foveal Avascular Zone Measured by Optical Coherence Tomography Angiography and Visual Acuity in Diabetic Retinopathy: A Systematic Review

FAZ area, particularly in the DVP, shows the most consistent association with visual acuity in DR, while circularity and perimeter demonstrate variable and limited standalone value. However, current evidence is limited by methodological variability and high heterogeneity across studies. Standardization of study methods, OCTA acquisition, and segmentation are essential to enable reliable translational and clinical application of FAZ-based biomarkers. Hybrid, multimodal, and artificial intelligence-based approaches may enhance future longitudinal prediction models.