Diabetic Retinopathy and Current Treatment Approaches: From Pathogenesis to Extracellular Vesicle-Based Therapies

Diabetic retinopathy (DR) is the leading cause of vision loss in early adulthood, caused by disruption of the retinal microvasculature. In the early stages of DR, there is a loss of pericytes, the cells responsible for maintaining vascular stability. Pericytes are progenitor cells and possess stem cell properties such as the potential to differentiate into various cell types, surface markers similar to mesenchymal stem cells (MSCs), and the ability to modulate the immune response. Human adipose-derived MSCs, when cultured with certain growth factors, acquire a pericyte-like phenotype, which expands the potential for pericyte applications in therapy. Current treatments for DR include anti-vascular endothelial growth factor agents, corticosteroids, and laser photocoagulation. All of these treatments are symptomatic and have adverse effects. This review covers the prevalence of DR in Kazakhstan and worldwide, the pathogenesis of the disease at the molecular and clinical level, treatment methods and modern approaches based on stem cells and pericytes.