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Peer-reviewedCC BY-NC-ND 4.0Translational Vision Science & Technology

Foveal Avascular Zone and Its Associations – An Analysis Using OCTA: Results From the Gutenberg Health Study

  • Anna Maria Welzel1
  • Felix M. Wagner1
  • Katrin Lenz1
  • Adrian Gericke1,2
  • Achim Fieß1
  • Philipp S. Wild3,4,5,6
  • Karl J. Lackner7
  • Manfred E. Beutel8
  • Irene Schmidtmann9
  • Thomas Münzel10
  • Oliver Tüscher11,12
  • Jörn Schattenberg13,14
3 more authors
  • Stavros Konstantinides4
  • Norbert Pfeiffer1
  • Alexander K. Schuster1
14 affiliations
  1. 1Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
  2. 2Vista Alpina Eye Clinic, Visp, Switzerland
  3. 3Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
  4. 4Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany
  5. 5German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany
  6. 6Systems Medicine, Institute of Molecular Biology (IMB), Mainz, Germany
  7. 7Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
  8. 8Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
  9. 9Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
  10. 10Department of Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
  11. 11Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
  12. 12Leibniz Institute for Resilience Research, Mainz, Germany
  13. 13Department of Internal Medicine I, University Medical Center, Mainz, Germany
  14. 14Department of Internal Medicine II, University Medical Center Saarland, Homburg, Germany
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Abstract

Purpose: The aim of this study was to describe the distribution and ocular and systemic associations of the foveal avascular zone (FAZ) area in Caucasians in a population-based setting.

Methods: We included 1004 participants (aged 59.91 ± 9.39 years; 49.3% female) of the 10-year follow-up of the Gutenberg Health Study, a population-based, prospective cohort Study in Mainz, Germany, with gradable optical coherence tomography angiography of the macula. The FAZ area of the total retina was measured manually. Linear regression analysis was conducted to evaluate the associations of the FAZ area with ocular and systemic factors.

Results: The mean FAZ area was 0.27 ± 0.12 mm2. It was associated with female sex (B-estimate 0.04; 95% confidence interval [CI], 0.03–0.06; P < 0.001) and inversely with axial length (B-estimate −0.02; 95% CI, −0.03 to −0.01; P < 0.001). Multivariable analysis of the FAZ area confirmed the associations with sex and axial length. No association was found with age, body mass index, blood pressure, diabetes, smoking, chronic kidney disease, socioeconomic status, or best-corrected visual acuity.

Conclusions: The FAZ area was larger in females and in participants with a shorter axial length indicating that both ocular and anthropometric factors may influence FAZ size.

Translational Relevance: This study provides normative data of the foveal avascular zone area in an adult Caucasian population and describes the ocular and systemic associations that have to be taken into account when interpreting optical coherence tomography angiography data in Caucasians.

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Cite

BibTeXRIS
BibTeX
@article{welzel2026foveal,
  title = {{Foveal Avascular Zone and Its Associations – An Analysis Using OCTA: Results From the Gutenberg Health Study}},
  author = {Anna Maria Welzel and Felix M. Wagner and Katrin Lenz and Adrian Gericke and Achim Fieß and Philipp S. Wild and Karl J. Lackner and Manfred E. Beutel and Irene Schmidtmann and Thomas Münzel and Oliver Tüscher and Jörn Schattenberg and Stavros Konstantinides and Norbert Pfeiffer and Alexander K. Schuster},
  journal = {Translational Vision Science \& Technology},
  year = {2026},
  month = oct,
  doi = {10.1167/tvst.15.10.39},
  url = {https://doi.org/10.1167/tvst.15.10.39},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Foveal Avascular Zone and Its Associations – An Analysis Using OCTA: Results From the Gutenberg Health Study
AU  - Anna Maria Welzel
AU  - Felix M. Wagner
AU  - Katrin Lenz
AU  - Adrian Gericke
AU  - Achim Fieß
AU  - Philipp S. Wild
AU  - Karl J. Lackner
AU  - Manfred E. Beutel
AU  - Irene Schmidtmann
AU  - Thomas Münzel
AU  - Oliver Tüscher
AU  - Jörn Schattenberg
AU  - Stavros Konstantinides
AU  - Norbert Pfeiffer
AU  - Alexander K. Schuster
PY  - 2026
DA  - 2026/10/26
JO  - Translational Vision Science & Technology
DO  - 10.1167/tvst.15.10.39
UR  - https://doi.org/10.1167/tvst.15.10.39
AB  - Purpose: The aim of this study was to describe the distribution and ocular and systemic associations of the foveal avascular zone (FAZ) area in Caucasians in a population-based setting.  Methods: We included 1004 participants (aged 59.91 ± 9.39 years; 49.3% female) of the 10-year follow-up of the Gutenberg Health Study, a population-based, prospective cohort Study in Mainz, Germany, with gradable optical coherence tomography angiography of the macula. The FAZ area of the total retina was measured manually. Linear regression analysis was conducted to evaluate the associations of the FAZ area with ocular and systemic factors.  Results: The mean FAZ area was 0.27 ± 0.12 mm2. It was associated with female sex (B-estimate 0.04; 95% confidence interval [CI], 0.03–0.06; P < 0.001) and inversely with axial length (B-estimate −0.02; 95% CI, −0.03 to −0.01; P < 0.001). Multivariable analysis of the FAZ area confirmed the associations with sex and axial length. No association was found with age, body mass index, blood pressure, diabetes, smoking, chronic kidney disease, socioeconomic status, or best-corrected visual acuity.  Conclusions: The FAZ area was larger in females and in participants with a shorter axial length indicating that both ocular and anthropometric factors may influence FAZ size.  Translational Relevance: This study provides normative data of the foveal avascular zone area in an adult Caucasian population and describes the ocular and systemic associations that have to be taken into account when interpreting optical coherence tomography angiography data in Caucasians.
SN  - 2164-2591
ER  -