OBJECTIVE: To evaluate changes in retinal layer thickness and microvascular density in pancreatitis patients using optical coherence tomography angiography (OCTA). METHODS: The study involved 16 pancreatitis patients and 16 healthy controls. Each participant underwent a superficial OCTA scan, with images divided into nine subregions to compare macular retinal thickness (RT) and superficial vascular density (SVD) between groups. RESULTS: Pancreatitis patients exhibited reduced retinal thickness in specific macular areas, including inner, full, and outer layers (p < 0.05). Additionally, decreased superficial vascular density was noted in inner superior (IS), outer superior (OS), inner nasal (IN), and outer nasal (ON) regions (p < 0.05). ROC curve analysis showed high diagnostic accuracy for full-layer inner superior, outer superior, and outer inferior thickness with areas under the curve of 0.9429, 0.9233, and 0.9990, respectively. CONCLUSIONS: Pancreatitis is associated with macular retinal thinning and decreased superficial vascular density, offering potential for improved diagnostic imaging.