A systematic review and meta-analysis included 16 studies of 545 patients (547 eyes) with retinal vein occlusion (RVO) treated with anti-VEGF therapy. There was a significant reduction in choroidal thickness after 1 and 3 months of treatment, with choroidal thickness approaching baseline at 12 months, indicating stabilization or structural adaptation. The effects differed according to the type of anti-VEGF drug: ranibizumab and aflibercept showed early reductions in thickness, while bevacizumab had a more delayed effect. In branch retinal vein occlusion, a significant reduction in choroidal thickness was observed after 1 month, in contrast to central retinal vein occlusion, where this effect was not significant. The study draws attention to the limited number of available works and the heterogeneity of the studies, therefore the results are preliminary and require careful interpretation. Future studies with larger numbers of patients and standardized methods are needed to better understand the clinical significance of these changes. The registration of the systematic review is CRD 420251011228.