Background: Chronic obstructive pulmonary disease (COPD) has multi-systemic implications and comorbidities. Fine ocular structures are affected by hypoxia and systemic inflammation. Objective: To evaluate the changes in the retina and choroid in patients with chronic obstructive pulmonary disease using spectral-domain optical coherence tomography (SD-OCT). Patients and methods: This prospective case control study included a total of forty COPD patients and twenty ageand sex-matched healthy individuals as control group; both eyes were included. COPD patients were divided into two subgroups; a group with mild to moderate COPD and another group with severe to very severe COPD according to the Global Initiative for COPD guideline. COPD patients were subjected to spirometry. Arterial blood gas analysis was performed to determine hypoxic state. The subfoveal choroidal thickness (SFCT), macular thickness (MT) and retinal nerve fiber layer (RNFL) thickness were measured using SD-OCT and compared between groups. Results: There was no statistically significant difference between groups according to demographic data. Mean SFCT was statistically significantly thinner in COPD groupsthan in the control group; and this thinning was more pronounced with increase in the severity of COPD. As regard to MT, no statistically significant difference was observed between groups (p=0.691). Peripapillary RNFL was significantly thinner in COPD group than the control group in all quadrants except the superior one. Conclusion: Changes in the SFCT and RNFL thickness could be used as indicators for the severity of COPD