The authors report a cross-sectional study which was conducted to investigate the correlation between aqueous flare and macular microvascular status, assessed by optic coherence tomography angiography (OCTA) in diabetes mellitus. Fifty-two diabetic patients with non-proliferative retinopathy, 44 diabetic patients without retinopathy, and 20 nondiabetic age matched controls were included. Spectral domain OCT, OCTA, and laser flare-cell meter were performed. The mean ages were 50.8 ±15.6 (29-79), 55.5 ±10.8 (19-71), and 58.1 ±10.1 (27-72), respectively. The three groups of patients did not differ significantly with respect to age (p=0.419) and body mass index (p=0.453). Duration of diabetes was higher for eyes with diabetic retinopathy (DR) when compared to those without retinopathy (p=0.018). Best corrected visual acuity of diabetic eyes with retinopathy, diabetic eyes without retinopathy, and controls were 0.028 ±0.11, 0.011 ±0.041, and 0.00 ±0.00 logMAR, respectively (p=0.313). In comparison to controls and diabetic eyes without retinopathy, the retinopathy group had an enlarged foveal avascular zone (FAZ) area (p=0.008 and p<0.001, respectively) and an enlarged capillary non-flow area (p<0.001 and p<0.001, respectively). Compared to eyes without retinopathy, eyes with retinopathy had higher flare intensity (p=0.024), enlarged capillary nonperfusion area (p<0.001), and enlarged foveal avascular zone (p<0.001). There was a significant correlation between flare intensity and capillary nonperfusion areas (p<0.001, r=0.511) and superficial capillary density (p=0.005, r=–0.388) in diabetic eyes with retinopathy. Conclusion: The results demonstrated a positive correlation between aqueous flare levels, an indicator of intraocular inflammation, and microvascular damage demonstrated by OCTA in the early stages of DR. This finding supports the role of inflammation in the pathogenesis of diabetic retinopathy.