Obstructive sleep apnea syndrome (OSA) is a common morbid disease, its association with diabetic retinopathy, this meta-analysis aimed to assess the relationship between OSA, and continuous positive airway pressure and diabetic retinopathy/maculopathy. We systematically searched PubMed, Medline, and Google Scholar with interest in articles reporting the relationship between obstructive sleep apnea and continuous positive airway pressure on diabetic retinopathy/maculopathy. The terms "obstructive sleep apnea", "continuous positive airway pressure", "diabetic retinopathy/maculopathy "were used. No limitation was set for the study period (from the first published article until November 2021). A pre-determined table was used to collect study information including author name, year of publication, patients number in the intervention and control groups, the study duration. Out of the 201 studies retrieved, 25 full articles were approached and nine cohorts fulfilled the inclusion and exclusion criteria. we pooled six studies (16-21); three were case-control, one prospective, a retrospective, and a cross-sectional study. Three were from Europe, one from Australia, one published in Asia, and one from Tunesei (15152 patients and 382 events). No association was found between obstructive sleep apnea and diabetic retinopathy progression, odd ratio, 1.27, 95% CI, 0.79-2.04, P-value, 0.33. Three studies (two from Europe and one from the USA, 361 patients, and 286 events) assessed the effect of CPAP on diabetic retinopathy and maculopathy with no significant effect, odd ratio, 1.15, 95% CI, 0.41-3.23, P-value, 0.79. No association was found between OSA, CPAP, and diabetic retinopathy.