Beyond hyperglycaemia: diabetic retinopathy is a multifactorial complication of diabetes mellitus

INTRODUCTION: The remarkable researches have been made to clarify the pathogenesis of DR, but relatively little is known about it. The goal was to summarize the epidemiology and mechanism of DR, provide screening and biomarker information of DR and suggest the strategies for treatment and intervention of DR. METHODS: This article synthesizes recent findings on intricate interrelated patho-physiological mechanisms elicited by hyperglycaemia underlie the progression of DR. RESULTS: DR has long been considered a microvascular disorder, but accumulating evidences demonstrate that retinal neurodegeneration like activated microglial is involved as well. The progression of DR is underpinned by complex, interconnected pathophysiological mechanisms triggered by hyperglycaemia, including vascular endothelial growth factor (VEGF), methylglyoxal (MGO), Wnt signalling pathways, retinal neurodegeneration and other factors. Enhanced comprehension of the fundamental pathophysiological mechanisms, coupled with advancements in computer technology, fosters the development of innovative approaches to screening, diagnosis and early intervention for DR. CONCLUSION: DR, a multifactorial complication of diabetes mellitus, necessitates continued research into precise screening methodologies and targeted therapeutic strategies.