Introduction
Diabetic retinopathy (DR) stands as a prevalent complication of diabetes mellitus, imposing a substantial burden on individuals worldwide and serving as a leading cause of vision impairment among the middle-aged and elderly populations (1). The progression of DR encompasses various stages, ranging from the initial microvascular alterations to advanced manifestations such as proliferative DR and diabetic macular edema, which significantly compromise visual function (2). Traditionally conceived as primarily a microvascular disorder, emerging evidence underscores the intricate involvement of retinal neurodegeneration in the pathogenesis of DR.
Pathophysiological insights: beyond microvasculature
DR is a multifaceted disease driven by a persistent hyperglycemic environment characteristic of diabetes. Beyond microvascular alterations, the pathophysiological mechanisms orchestrating DR onset and progression are diverse and interconnected (3). Genetic predisposition, epigenetic modifications, oxidative stress-induced free radical generation, accumulation of advanced glycosylation end products, inflammatory mediators, and dysregulated vascular endothelial growth factor (VEGF) signaling collectively contribute to the intricate landscape of DR pathogenesis (4). This intricate interplay of molecular pathways underscores the heterogeneous nature of DR, posing a significant challenge in devising tailored therapeutic strategies for individual patients.
Advancements in personalized medicine
The identification of distinct phenotypes of DR, characterized by unique molecular signatures and varying risks for vision-threatening complications, represents a significant breakthrough in patient stratification (5). Molecular profiling techniques, including genomics, proteomics, and metabolomics, have provided valuable insights into the underlying pathophysiological mechanisms of DR (6). By tailoring treatment strategies to match individual patient profiles, personalized medicine holds promise for optimizing therapeutic outcomes and minimizing treatment-related adverse effects.
Optimization of current treatment strategies
While anti-VEGF therapy and laser photocoagulation remain the mainstays of treatment for diabetic macular edema and proliferative DR, respectively, personalized medicine offers the opportunity to refine and optimize these approaches. Targeted therapies, guided by the specific molecular characteristics of each patient’s disease, have the potential to enhance treatment efficacy and improve long-term visual outcomes (7, 8). By minimizing treatment burden and maximizing therapeutic benefit, personalized approaches aim to improve patient adherence and quality of life.
Challenges and opportunities
Despite the significant progress made in personalized medicine for DR, several challenges remain. Integration of omics technologies into clinical practice presents logistical and technical hurdles, including standardization of methodologies and interpretation of complex data sets (9). Additionally, the cost-effectiveness and accessibility of personalized approaches must be carefully considered to ensure equitable access to care for all patients (10). However, with continued advancements in technology and collaboration between researchers, clinicians, and industry partners, personalized medicine holds the promise of revolutionizing the management of DR and improving outcomes for patients worldwide.
Conclusions
In conclusion, the journey towards personalized medicine in DR represents a transformative paradigm shift, poised to revolutionize our approach to patient care and therapeutic decision-making. By embracing the principles of precision medicine and harnessing the power of molecular profiling and biomarker-driven strategies, we can strive towards optimizing visual outcomes and enhancing the quality of life for individuals afflicted with this sight-threatening complication of diabetes.
Statements
Author contributions
KJ: Writing – review & editing, Writing – original draft. HY: Writing – review & editing. WW: Writing – review & editing. AG: Writing – review & editing.
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Generative AI statement
The author(s) declare that no Generative AI was used in the creation of this manuscript.
Publisher’s note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
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Summary
Keywords
diabetes retinopathy, etiology, biomarker, diagnosis, treatment
Citation
Jin K, Yu H, Wei W and Grzybowski A (2025) Editorial: Personalized medicine of diabetes retinopathy: from bench to bedside. Front. Endocrinol. 16:1597332. doi: 10.3389/fendo.2025.1597332
Received
21 March 2025
Accepted
21 March 2025
Published
01 April 2025
Volume
16 - 2025
Edited and reviewed by
Åke Sjöholm, Gävle Hospital, Sweden
Updates
Copyright
© 2025 Jin, Yu, Wei and Grzybowski.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Kai Jin, jinkai@zju.edu.cn
Disclaimer
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.