Current status of research on the treatment of diabetic retinopathy with traditional Chinese medicine

This review aims to investigate the current research on diabetic retinopathy (DR) and explores the therapeutic potential of traditional Chinese medicine (TCM) monomers in its management. A comprehensive literature analysis was conducted on DR pathophysiology, current treatment strategies, and the pharmacological properties of key TCM monomers, including Astragaloside IV (AS-IV), Puerarin (PUR), Salidroside (SAL), Berberine (BBR), and Scutellarin (SCU). While Western therapies such as anti-VEGF agents have shown efficacy, their clinical use is often limited by frequent intravitreal injections and associated risks. In contrast, preclinical studies indicate that TCM monomers may offer multi-target therapeutic benefits. AS-IV has been shown to reduce retinal cell death and oxidative stress; PUR enhances microvascular function and inhibits apoptosis; SAL attenuates oxidative damage and preserves retinal barrier integrity; BBR suppresses neovascularization and cell apoptosis; and SCU prevents angiogenesis and barrier disruption. These compounds act through mechanisms involving antioxidation, anti-inflammation, and regulation of glucose metabolism, and generally exhibit favorable safety profiles. However, their precise molecular targets remain inadequately defined, and robust clinical evidence is lacking. Further studies are needed to clarify their mechanisms of action and assess their translational potential in clinical settings.