Evaluation of the Foveal Avascular Zone in Highly Myopic Patients: A Systematic Review

Abstract

This research aimed to evaluate the relationship between the foveal avascular zone (FAZ) and high myopia, exploring its prevalence, characteristics and clinical implications, in addition to investigating the association between the extent of the FAZ and the severity of myopia, as well as the effectiveness of available diagnostic and therapeutic methods. For this purpose, a systematic review was carried out based on 12 studies published between 2018 and 2025, obtained results from large scientific databases, and data on the prevalence of the FAZ, its expansion proportional to the severity of myopia, and the application of technologies such as optical coherence tomography angiography (OCTA) were analyzed. From this, the findings demonstrated that the FAZ increased proportionally to the ocular axial elongation, with an average of 0.05 to 0.07 mm² per additional diopter; OCTA showed 92% sensitivity in the detection of microvascular changes and allowed the identification of patterns associated with the progression of myopia; as well as therapeutic interventions, such as the use of anti-VEGF agents, reduced the FAZ area by up to 15% in six months. Therefore, FAZ proved to be a significant marker in high myopia, providing support for early diagnosis and targeted therapies, promoting better clinical outcomes.