A Recent Update on Candidate Biomarkers in the Pathogenesis of Diabetic Retinopathy

Diabetic Retinopathy (DR), a retinal vascular disease caused by hyperglycemia, is the most common microvascular consequence of diabetes that affects a significant proportion of young adults. The transition from the non-proliferative to the proliferative stage results in vitreous hemorrhage, retinal detachment, and ultimately irreversible blindness. Currently, there are no effective interventions to support the early treatment of diabetic retinopathy. Non-invasive methods, such as AI-mediated deep learning, are useful for screening and diagnosing DR once visual changes become evident. These methods also help assess whether current treatments are improving vision. Furthermore, existing pharmaceutical therapies are typically employed only when vision is already impaired. Therefore, to predict the onset of the disease, monitor its progression, and identify new therapeutic targets, it is crucial to search for optimal biomarkers that have high specificity and sensitivity related to the pathogenesis of DR.

This narrative review aims to address the regulation of circulating biomarkers in DR, with a particular emphasis on its pathogenesis, which includes inflammation, oxidative stress, angiogenesis, and neurodegeneration, as well as the associated therapies. It also discusses the role of nutritional factors in DR and highlights studies conducted on human populations to date.

A review was conducted using databases from the Cochrane Library and search engines such as PubMed, Google Scholar, Research Gate, and Scopus. The study included Type 2 Diabetes Mellitus (T₂DM) with or without diabetic retinopathy. Exclusion criteria includedstudies conducted in Gestational diabetes mellitus, Type 1 Diabetes mellitus, editorial, pilot studies, conferences, abstracts, interviews, thesis, and unpublished work.

Results: Based on the putative molecular targets of these biomarkers, future research may successfully create novel therapeutics to reduce the overall burden of the disease and enhance the visual outcome of diabetic patients

Ultimately, this could improve patients' quality of life by reducing the impact of vision loss and alleviating the overall burden of the disease.