{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T02:29:35Z","timestamp":1792031375003,"version":"4.4.0"},"reference-count":37,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Central retinal artery occlusion (CRAO) is a vision-threatening condition with limited evidence-based treatment options. Hyperbaric oxygen therapy (HBOT) has emerged as a potential intervention, but its efficacy remains debated. This systematic review and meta-analysis evaluated the therapeutic efficacy and safety of HBOT in CRAO. Methods: Relevant studies were identified across seven databases using optimized Boolean and MeSH-based strategies. Eligible studies evaluated HBOT in CRAO and reported visual or safety outcomes. Extracted data included demographics, intervention details, treatment timing, visual acuity outcomes, and adverse events. Risk of bias was assessed using ROBINS-I. Visual acuity outcomes were standardized to logMAR whenever directly reported or convertible, and subgroup analyses were stratified by HBOT initiation time (&lt;12 h vs. &gt;12 h), study type, and baseline visual severity when reported. A random-effects model was used, and pooled estimates were expressed as odds ratios (ORs) with 95% confidence intervals (CIs). Results: Twelve studies were included. The pooled efficacy analysis favored HBOT (OR = 0.47; 95% CI: 0.26\u20130.87; p = 0.02), although heterogeneity was substantial (Tau2 = 0.64; I2 = 78%). Stratified synthesis showed that studies in which HBOT was initiated within 12 h consistently reported greater visual improvement, whereas delayed or variably timed treatment showed attenuated and inconsistent benefits. After outcome harmonization, studies reporting logMAR-compatible data generally demonstrated clinically relevant visual improvement, while adverse-event rates did not differ significantly between HBOT and non-HBOT groups (OR = 0.70; 95% CI: 0.43\u20131.16; p = 0.17; I2 = 0%). Conclusions: HBOT appears most beneficial when initiated early, particularly within the first 12 h. However, heterogeneity in treatment timing, study design, and baseline severity reporting limits the certainty of these results and supports the need for standardized outcome reporting and protocol-driven prospective studies.<\/jats:p>","DOI":"10.3390\/jcm15093530","type":"journal-article","created":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T13:23:37Z","timestamp":1777987417000},"page":"3530","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Therapeutic Efficacy of Hyperbaric Oxygen in Central Retinal Artery Occlusion: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"15","author":[{"given":"Hani Basher","family":"ALBalawi","sequence":"first","affiliation":[{"name":"Division of Ophthalmology, Department of Surgery, Faculty of Medicine, University of Tabuk, Tabuk 47512, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6350-7464","authenticated-orcid":false,"given":"Moustafa S.","family":"Magliyah","sequence":"additional","affiliation":[{"name":"Vitreoretinal Division, King Khaled Eye Specialist Hospital, Riyadh 11462, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8860-543X","authenticated-orcid":false,"given":"Naif M.","family":"Alali","sequence":"additional","affiliation":[{"name":"Division of Ophthalmology, Department of Surgery, Faculty of Medicine, University of Tabuk, Tabuk 47512, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed M.","family":"Alshehri","sequence":"additional","affiliation":[{"name":"Diving and Hyperbaric Medicine Department, NEOM Hospital, Sharma 49626, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2976-8254","authenticated-orcid":false,"given":"Abdullah","family":"Alhewiti","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, Faculty of Medicine, University of Tabuk, Tabuk 47512, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2470-8076","authenticated-orcid":false,"given":"Faisal","family":"Almarek","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Faculty of Medicine, Imam Mohammad ibn Saud Islamic University, Riyadh 13317, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Shajry","sequence":"additional","affiliation":[{"name":"Ophthalmology Department, King Khaled University Medical City, Abha 62529, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad A.","family":"Hazzazi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Ophthalmology, National Guard Hospital, Riyadh 14611, Saudi Arabia"},{"name":"College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 14611, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0648-933X","authenticated-orcid":false,"given":"Yousef A.","family":"Alotaibi","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, College of Medicine, King Khalid University, Abha 61413, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3443","DOI":"10.2147\/OPTH.S224192","article-title":"Hyperbaric Oxygen Therapy for Central Retinal Artery Occlusion: Patient Selection and Perspectives","volume":"15","author":"Celebi","year":"2021","journal-title":"Clin. 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