AIM:To systematically evaluate the changes in retinal and choroidal thickness in patients with internal carotid artery stenosis by using optical coherence tomography(OCT)through Meta-analysis.METHODS: Literatures on the measurement of retinal and choroidal structure in patients with internal carotid artery stenosis by using OCT from CNKI, VIP, WF, PubMed, the Cochrane Library, SinoMed, and Embase databases were searched for relevant studies. The retrieval time was from the establishment of the databases to January 2024. In addition, quality of the included literatures was assessed by the Newtle-Ottawa scale(NOS), and RevMan 5.4.1 and Stata 16.0 were used for statistical analysis.RESULTS: A total of 17 articles(including 18 studies)were included, and the Meta-analysis results showed that, patients with internal carotid artery stenosis had significantly thinner peripapillary retinal nerve fiber layer(pRNFL), ganglion cell complex(GCC), center macular thickness(CMT), and subfoveal choroidal thickness(SFCT)than the healthy control group(age matched normal population). The pRNFL and SFCT of the ipsilateral eye in patients with internal carotid artery stenosis become thinner compared with the contralateral eye.CONCLUSION:To a certain extent, the morphological structure of the retina and choroid can be altered by stenosis of the internal carotid artery. OCT can non-invasively detect the microstructural changes of the retina and choroid in patients with internal carotid artery stenosis, and can be used for the evaluation of internal carotid artery stenosis.