Diabetic retinopathy is a common microvascular complication of diabetes. Typical symptoms include decreased vision, distorted vision, and irreversible blindness. Its pathological features are microaneurysms, hemorrhage, exudation and neovascularization. Long-term hyperglycemia is the main inducement, and patients with poor glycemic control are more susceptible. Other risk factors include hypertension, hyperlipidemia, long duration of diabetes, pregnancy, etc. Smoking and genetic factors may also increase the risk.
According to disease progression, it can be divided into two categories: non-proliferative and proliferative stages.
- Non-Proliferative Diabetic Retinopathy
Early manifestations include retinal microaneurysms, hemorrhages and hard exudates. At this stage, the basement membrane of retinal capillaries thickens, pericytes decrease, and vascular permeability increases. Patients may present with blurred vision, floaters and other symptoms. Fundus fluorescein angiography is required for definite diagnosis. - Proliferative Diabetic Retinopathy
With disease progression, neovascularization and fibrous proliferation occur in the retina, which can lead to severe complications such as vitreous hemorrhage and tractional retinal detachment. In this stage, the patient’s vision declines sharply, and visual field defects may occur. Optical coherence tomography helps to evaluate the condition.
Diagnosis mainly relies on fundus fluorescein angiography (FFA) and optical coherence tomography (OCT). Treatments include laser photocoagulation to control ischemic damage, intravitreal anti-VEGF injections for macular edema, and vitrectomy in advanced stages.
Studies have shown that ginsenoside Rd improves early vascular injury through the AMPK-SIRT1 pathway, and GLP-1 receptor agonists exert protective effects by inhibiting the STING pathway. The artificial intelligence system DeepDR enables automatic diagnosis throughout the disease course and recommendation of screening intervals through fundus image analysis.