Diabetic Retinopathy and Oxidative Stress: Molecular Mechanisms, Diagnostic Strategies, and Advances in Antioxidant Therapies

A special issue of Antioxidants (ISSN 2076-3921). This special issue belongs to the section "Health Outcomes of Antioxidants and Oxidative Stress".

Deadline for manuscript submissions: 31 January 2026 | Viewed by 1369

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Department of Physiology, Faculty of Pharmacy, University of Valencia, Vicente Andrés Estellés Av. s/n, 46100 Burjassot, Spain
Interests: biochemistry; genetics and molecular biology medicine pharmacology; toxicology; pharmaceutics; immunology; microbiology; agricultural and biological sciences; engineering; neuroscience; chemistry; physics and astronomy; environmental science; oxidative stress; diabetic retinopathy; antioxidants; natural products; polyphenols
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Guest Editor
Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, E46010 Valencia, Spain
Interests: nutrition; longevity; aging; oxidative stress and exercise
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Diabetic retinopathy is a progressive asymptomatic neurovascular complication of diabetes that results in irreversible retinal damage. The rising prevalence of diabetes has established it as the leading cause of preventable blindness, particularly among the working-age population worldwide. Diabetic retinopathy exhibits a complex etiology, which complicates the understanding of how diabetes induces this pathology. However, there is a strong consensus on the pivotal role of oxidative stress, triggered by disrupted glycemic homeostasis, in the development and progression of diabetic retinopathy. Current treatments primarily address diabetic retinopathy in its advanced stages, when vision has already been substantially compromised. Therefore, early diagnosis and clinical interventions are essential to prevent disease progression and avoid irreversible retinal damage.

This Special Issue will explore the role of oxidative stress in the pathogenesis of diabetic retinopathy, with a focus on the molecular pathways involved in disease onset and progression, innovative diagnostic methods to improve sensitivity in disease staging, the identification of clinically relevant biomarkers, and the development of novel antioxidant therapeutic strategies. We welcome authors to contribute original research articles, clinical trials, traditional reviews, and systematic reviews to advance our understanding of the disease and foster progress in its diagnosis and treatment.

We look forward to your contribution.

Dr. Ángel Luis Ortega
Dr. Juan Gambini
Guest Editors

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Keywords

  • diabetic retinopathy
  • natural antioxidants
  • oxidative stress
  • epigenetic mechanisms
  • biomarkers
  • diagnostic methods

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Published Papers (2 papers)

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Research

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15 pages, 4245 KiB  
Article
Oxidative Stress and Complement Activation in Aqueous Cells and Vitreous from Patient with Vitreoretinal Diseases: Comparison Between Diabetic ERM and PDR
by Lucia Dinice, Pamela Cosimi, Graziana Esposito, Fabio Scarinci, Andrea Cacciamani, Concetta Cafiero, Luca Placentino, Guido Ripandelli and Alessandra Micera
Antioxidants 2025, 14(7), 841; https://doi.org/10.3390/antiox14070841 - 8 Jul 2025
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Abstract
Background: Epiretinal membrane (ERM) and proliferative diabetic retinopathy (PDR) belong to the group of vitreoretinal diseases, characterized by impairments at both the retina and the vitreous. The non-diabetic and diabetic forms of ERM (no-dERM and dERM) as well as the PDR are caused [...] Read more.
Background: Epiretinal membrane (ERM) and proliferative diabetic retinopathy (PDR) belong to the group of vitreoretinal diseases, characterized by impairments at both the retina and the vitreous. The non-diabetic and diabetic forms of ERM (no-dERM and dERM) as well as the PDR are caused by microvascular disorder, which frequently occurs in association with inflammation and oxidative stress. To better characterize no-dERM, dERM, and PDR at the biomolecular level, we compared the expression of inflammatory, oxidative, lipidic peroxidation products, and complement receptors. Methods: Twenty-seven ocular fluids from patients who underwent phaco-vitrectomy were categorized as no-dERM (9, 4M/5F; 70.4 ± 6.4), dERM (6, 3M/3F; 73.2 ± 4.9), and PDR (6, 5M/1F; 63.7 ± 7.4). Six cataracts (CTR; 3M/3F; 77.7 ± 9.0) were collected for internal control of aqueous cells. Results: In aqueous cells, p65NFkB, iNOS, Nox1/Nox4, and Nrf2 were significantly upregulated, and Keap1 was downregulated in dERM compared with PDR and no-dERM. In aqueous cells, a significant upregulation for C3aR1mRNA, C5aR1mRNA, and CFHmRNA were observed in dERM. In vitreous, C3a, C5b9, and MDA levels were significantly increased in dERM compared with PDR and no-dERM. Conclusions: Inflammatory and ROS products, as well as C3aR1/C5aR1 and soluble MDA, appear of great interest, as their expression in aqueous and vitreous might have potential prognostic and therapeutic values. Full article
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Review

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29 pages, 922 KiB  
Review
Modulation of Oxidative Stress in Diabetic Retinopathy: Therapeutic Role of Natural Polyphenols
by Verónica Gómez-Jiménez, Raquel Burggraaf-Sánchez de las Matas and Ángel Luis Ortega
Antioxidants 2025, 14(7), 875; https://doi.org/10.3390/antiox14070875 - 17 Jul 2025
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Abstract
Diabetic retinopathy (DR), a leading cause of blindness in working-age adults, arises from chronic hyperglycemia-induced oxidative stress, inflammation, and vascular dysfunction. Current therapies such as laser photocoagulation, intravitreal anti-vascular endothelial growth factor (VEGF) agents, and steroids target advanced stages but fail to prevent [...] Read more.
Diabetic retinopathy (DR), a leading cause of blindness in working-age adults, arises from chronic hyperglycemia-induced oxidative stress, inflammation, and vascular dysfunction. Current therapies such as laser photocoagulation, intravitreal anti-vascular endothelial growth factor (VEGF) agents, and steroids target advanced stages but fail to prevent early neuronal and microvascular damage. Emerging evidence highlights oxidative stress as a key driver of DR pathogenesis, disrupting the blood-retinal barrier (BRB), promoting neurodegeneration and angiogenesis. Advances in imaging, particularly optical coherence tomography angiography (OCTA), enable earlier detection of neurodegeneration and microvascular changes, underscoring DR as a neurovascular disorder. Polyphenols, such as resveratrol, curcumin, and pterostilbene, exhibit multitarget antioxidant, anti-inflammatory, and anti-angiogenic effects, showing promise in preclinical and limited clinical studies. However, their low bioavailability limits therapeutic efficacy. Nanotechnology-based delivery systems enhance drug stability, tissue targeting, and sustained release, offering potential for early intervention. Future strategies should integrate antioxidant therapies and precision diagnostics to prevent early irreversible retinal damage in diabetic patients. Full article
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