The beneficial effects of Traditional Chinese Medicine on diabetic retinopathy: mechanisms, therapeutics, and prospects

Diabetic retinopathy (DR) is a common microvascular sequela of diabetes mellitus. Chronic hyperglycemia contributes to progressive retinal microvascular damage, thereby increasing the risk of visual impairment and irreversible blindness. Traditional Chinese Medicine (TCM) has historically been effective against diabetes and related diseases such as retinopathy. It treats DR based on syndrome differentiation, with individualized regimens tailored to patients’ specific conditions and physical constitutions. This review discusses the pathogenesis of DR in modern medicine and TCM. It also summarizes four therapies for DR, including formulas, Chinese herbs, active components, and acupuncture. We systematically gathered and arranged the pertinent literature on DR from various databases, including PubMed, Web of Science, and ScienceDirect. We analyzed and summarized research advances in TCM for the treatment of DR. Moreover, the GSE60436 dataset was chosen to dissect the variations in gene expression and signaling pathways connected to DR, employing Gene Ontology (GO) enrichment analysis and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway database. Bioinformatics studies have indicated a potential link between the development of DR and the phosphatidylinositol 3-kinases-protein kinase B (PI3K-Akt) and advanced glycation end products (AGE)-receptors for advanced glycation end products (RAGE) pathways. At the same time, we emphasized the cutting-edge targets and strategies for DR treatment interventions. TCM exhibits a distinctive therapeutic efficacy in preventing and treating ocular conditions and mitigating DR via various mechanisms and routes. According to the principle of holistic treatment based on syndrome differentiation in TCM, choosing appropriate TCM treatments has the advantage of improving the clinical efficacy and mitigating adverse effects of Western medications.