Introduction This study aimed to evaluate ocular alterations, especially in the retinal microvasculature of obese patients and to determine the association of these alterations with clinical features. Materials and Methods In all participants,biochemical examinations were performed including cholesterol,fasting blood glucose,fasting insulin,CRP and HbA1C levels.The atherogenic index of plasma(AI) was calculated as a logarithm of the ratio of the molar concentration(mmol/l) of TG to HDL-C (log [TG/HDL-C]).Patients with a BMI of ≤25 kg/m2 were included in the control group. Obese patients were further divided into three groups according to their BMI:group 1 (BMI: 30-34.99 kg/m2),group 2 (BMI: 35-39.99 kg/m2), and group 3 (BMI ≥ 40 kg/m2).The foveal avascular zone (FAZ), the vessel density (VD) of the super cial capillary plexus and deep capillary plexus of the macula,and the VD of the retinal peripapillary capillary plexus for the optic disc were quantified by OCT-A. Results A total of 110 patients, 27 controls and 83 obese patients, were included in the study. The HbA1C, fasting insulin, HOMA-IR, C-reactive protein and AI levels were significantly higher in obese patients compared with the control cases. The superficial (p=0.003) and deep (p=0.001)VDs of the retina were significantly decreased and FAZ was significantly increased (p=0.032)in obese patients. In the correlation analysis performed between the clinical features and OCT-A findings, the superficial and deep VDs were inversely correlated with age,BMI, HbA1C and AI. Conclusion The retinal superficial and deep VDs were decreased in obese patients and there was an inverse relationship between the retinal VDs and age,BMI,HbA1C,and AI.