Basic research on diabetic retinopathy (DR) in 2025 focused on the dissection of pathological networks, biomarker discovery, and therapeutic target development, achieving multi‑dimensional breakthroughs covering immunity, metabolism, and the gut‑eye axis, and laying core evidence for precision diagnosis and treatment.
In terms of pathogenic mechanism networks:Studies revealed that high glucose drives angiogenesis via the perlecan‑HIF‑1α axis in monocyte‑derived exosomes;GLP‑1 receptor agonists protect vascular endothelial cells by inhibiting the STING pathway;hypoglycemia disrupts the blood‑retinal barrier through HIF‑1α/2α.Gut‑eye axis research identified indole‑3‑propionic acid for the first time as a biomarker of intestinal dysfunction in DR progression, expanding understanding of metabolic‑immune crosstalk.
In terms of molecular typing and early warning biomarkers:Proliferative DR was precisely classified into an immune‑defense subtype and an endothelial mitochondrial dysfunction subtype;tear lactate, aqueous humor RBP3, and plexin B2 were closely associated with DR progression.
Substantial progress was made in the translation of therapeutic targets and technology platforms:The EPCR‑HO‑1 axis and AGGF1‑TNFSF12/FN14 pathway can serve as intervention targets;MFAP4‑blocking antibodies showed efficacy in primate models;the EMDV nanosystem enables targeted regulation of mitochondrial homeostasis.The world’s first vascularized retinal organoid model was successfully constructed, integrating neural retina, vascular networks, and microglia. It dynamically simulates DR inflammation and blood‑retinal barrier disruption, providing a pathological microenvironment platform for high‑throughput screening of anti‑VEGF drugs.