AIM: To assess the changes of foveal avascular zone(FAZ)and vessel density(VD)using optical coherence tomography angiography(OCTA)in diabetic retinopathy(DR)patients.

METHODS: A systematic review of the literature was performed to examine the diagnostic used OCTA in DR to date. Six electronic databases were searched to find relevant studies. We conducted a literature search in English and Chinese databases. Two authors extracted basic data, the VD of superior capillary plexus(VD_SCP), the VD of deep capillary plexus(VD_DCP), the area and the perimeter of FAZ. We used a variety of Meta-analytic methods, including WMD forest maps, funnel plot, Begg test and sensitivity analysis, to confirm the final results.

RESULTS: Totally 24 studies recruiting 2 305 eyes were included. Patients with DR showed statistical difference in VD_SCP \〖WMD= -5.78, 95%CI (-7.67 to -3.88), P<0.05\〗, VD_DCP \〖WMD= -5.08, 95%CI(-6.49 to -3.67), P<0.05\〗, the perimeter of FAZ \〖WMD=0.57, 95%CI(0.36 to 0.78), P<0.05\〗, the area of FAZ \〖WMD=0.08, 95%CI (0.06 to 0.10), P<0.05\〗 with healthy controls.

CONCLUSION: In general, there was a trend towards a larger area and longer perimeter of FAZ in patients with DR. It can also be concluded that the VD of FAZ is higher in healthy controls. While questions remain regarding OCTA practical applicability in its present form, with continuing development and improvement of the technology, the diagnostic value of OCTA in DR is likely to become evident.