Transcriptome Analysis of Tear-Derived Extracellular Vesicles as Biomarkers for Diabetic Retinopathy

Diabetic retinopathy (DR) represents the predominant etiology of visual impairment and blindness on a global scale. At present, there is still a dearth of robust biomarkers for DR, which substantially limits its diagnosis, particularly at an early stage. Tears, owing to their inherent proximity to the ocular microenvironment, offer a unique advantage as a source of potential biomarkers for retinal pathologies. Specifically, tear-derived extracellular vesicles (tEVs) have emerged as promising candidates for this purpose, given their ability to reflect the physiological and pathological states of the retina. In this study, we conducted a comprehensive transcriptomic analysis of tEVs and identified a panel of tEV-mRNAs including ODF2L, TSR1, TONSL, and FUT6 as potential biomarkers for the diagnosis of DR. We validated this finding by using 119 tear samples from healthy controls and individuals with varying degrees of retinopathy. Considering the noninvasive and straightforward nature of tear fluid collection, the identified tEV-mRNAs hold significant promise for facilitating the early, noninvasive diagnosis and subsequent management of DR.