Retinal artery occlusion (RAO) is a vision-threatening condition with limited therapeutic options. Hyperbaric oxygen therapy (HBOT) has emerged as a potential treatment to enhance retinal oxygenation and salvage ischemic tissue, though its efficacy and safety remain debated.

We followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and the Cochrane Handbook for Systematic Reviews of Interventions. Databases were searched through November 2024 for studies comparing HBOT with control in RAO patients. Risk of bias was assessed using the Newcastle-Ottawa Scale. Meta-analyses evaluated visual acuity (VA), best-corrected visual acuity (BCVA) and adverse events (AEs).

Nine studies with 499 patients (286 HBOT, 213 non-HBOT) met the inclusion criteria. HBOT was associated with improved BCVA (MD: –0.63, 95% CI: [–1.14, –0.12], p = 0.01) after sensitivity analysis. No significant differences were observed in uncorrected VA or lines of improvement. AEs included seizures (1.47%), ear barotrauma (1.65%) and epistaxis (0.83%) in the HBOT group. Notably, HBOT was associated with lower rates of neovascular glaucoma (7.89% vs. 15.79%) and stroke (4.3% vs. 16.6%) compared to controls.

HBOT demonstrates potential for improved visual outcomes in RAO patients, particularly BCVA, with a generally favorable safety profile. However, heterogeneity among studies and limited sample sizes highlight the need for robust prospective trials to clarify its role in RAO management.

Endovascular thrombectomy (EVT) is the gold standard treatment for acute ischemic stroke (AIS) patients with large vessel occlusion (LVO). Multiple factors can influence EVT outcomes, including procedural and patient-related variables. This meta-analysis investigated the impact of periprocedural hemoglobin (Hb) levels on EVT outcomes.

We performed a comprehensive literature search across PubMed, Scopus, Web of Science and Cochrane CENTRAL. We analyzed the mean difference (MD) in Hb levels between good (modified Rankin Scale [mRS] 0–2) and poor (mRS 3–6) prognosis groups. We calculated pooled odds ratios (OR) for Hb levels as a predictor of prognosis and compared mortality and symptomatic intracranial hemorrhage (sICH) across different Hb levels.

The analysis included 921 patients from four studies. Patients in the good prognosis group had significantly higher Hb levels (MD: 0.48 g/dL, 95% CI: [0.2, 0.75], P = 0.0007). Each 1 g/dL increase in Hb was associated with a 22% increase in the odds of achieving a good three-month prognosis (OR: 1.22, 95% CI: [1.13, 1.33], P < 0.00001). Patients with Hb levels ≤13 g/dL in males and ≤12 g/dL in females were 1.69 times more likely to experience mortality (OR: 1.69, 95% CI: [1.1, 2.59], P = 0.02). No significant difference was observed in sICH occurrence between anemic and non-anemic patients.

Higher Hb levels may be associated with improved prognosis, and lower Hb levels might increase mortality risk in AIS-LVO patients undergoing EVT. Further research is needed to validate these findings.