Peng C, Li L, Yang M, et al. - In the present study, the researchers sought to assess alterations in sub‐macular choroidal thicknesses (sub‐MCT) in aquaporin‐4 immunoglobulin G antibodies (AQP4‐IgG) sero‐positive neuromyelitis optica spectrum disease (AQP4‐IgG+/NMOSD) and isolated ON (ION) patients using optical coherence tomography (OCT). In total, 208 ON patients (275 eyes) and healthy controls (HCs) who had sub‐MCT and retinal microstructure detection with OCT were involved. According to findings, the sub‐MCT in AQP4‐IgG+/NMOSD patients were decreased at all stages of ON, which distinguished the ION patients as declining only at the chronic ON stage. It suggested that ocular vascular hypoperfusion plays a potential role in ON pathogenesis and that the distinct pathogenesis of AQP4‐IgG+/NMOSD and ION may cause different patterns.