SIGNIFICANCE Regular physical activity may affect the neurovascular structures. Many studies have shown the positive effects of physical activity on ocular disorders such as glaucoma, retinopathy, and macular degeneration. Athletes were expected to have a better retinal vascular structure compared with the nonathletes. PURPOSE This study aimed to evaluate the effects of regular physical activity on the retinal microvascular structure. METHODS This observational and cross-sectional study was conducted between January and July 2020 with participants aged 20 to 35 years who had a visual acuity of >= 20/20, axial length of 22 to 24 mm, refractive defect spherical equivalent of <=+/- 1 D, and IOP of <= 21 mmHg. Updated AngioScan software (Navis version 1.8.0) of Nidek's RS-3000 Advance system was used to analyze the spectral-domain optical coherence tomography and optical coherence tomography angiography images. RESULTS A total of 60 right eyes of 60 individuals were included in the study. Thirty subjects were in the athlete group, and 30 patients were in the nonathlete group. Sixteen of the individuals in the athlete group and 15 in the nonathlete group were women (P > .05). Retinal nerve fiber layer and ganglion cell complex thicknesses in all quadrants were thinner in nonathletes (P < .05). All of the Early Treatment Diabetic Retinopathy Study regions except central foveal subfield thickness were significantly higher in the athlete group (P < .05). In the nonathlete group, significantly reduced vessel densities of the superficial and deep capillary plexus and radial peripapillary capillary plexus, and the foveal avascular zone circularity index along with an increased foveal avascular zone perimeter and area were also detected (P < .05). CONCLUSIONS Our study revealed that optical coherence tomography angiography measurements may be used in the determination of the effects of physical activity on retinal vascular structure changes.