Diabetic retinopathy: more than meets the eye
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Updated: Sep 27, 2026

Tear-Derived Exosomal miR-15a as New Diagnostic Tool for Diabetic Retinopathy
Published on: December 30, 2025
Thomas W Gardner1, David A Antonetti, Alistair J Barber
1Department of Ophthalmology, Penn State University College of Medicine, Hershey, PA 17033, USA.
Abstract:
Retinal microvascular dysfunction in diabetes is a major component of diabetic retinopathy. This review highlights recent observations regarding the cellular anatomy that contributes to the blood-retinal barrier and its breakdown, the alterations of macroglial, neuronal, and microglial cells in diabetes, and how these changes lead to loss of vision. In addition, the effects of systemic pathophysiologic influences, including metabolic control, blood pressure, and fluid volume on the formation of diabetic macular edema are discussed. Finally, an overview of inflammatory mechanisms and responses in the retina in diabetes is provided. Together, these new observations provide a broader clinical and research perspective on diabetic retinal vascular dysfunction than previously considered, and provide new avenues for improved treatments to prevent loss of vision.
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