Regulatory roles of non-coding RNAs in ferroptosis during diabetic retinopathy

Diabetic retinopathy (DR) is one of the most common and severe microvascular complications of diabetes, characterized by both microvascular damage and neurodegeneration. Despite advances in clinical management, current treatment options remain limited and lack effective therapeutic targets. Recent evidence has revealed that ferroptosis-an iron-dependent form of programmed cell death-plays a crucial role in the onset and progression of DR. Ferroptosis exacerbates DR pathology by disrupting the homeostasis of retinal vascular and neuronal systems. Moreover, accumulating studies have demonstrated that non-coding RNAs (ncRNAs), including microRNAs (miRNAs), long non-coding RNAs (lncRNAs), and circular RNAs (circRNAs), can modulate ferroptosis in DR through direct or indirect regulation of ferroptosis-related proteins and their downstream pathways. Elucidating the molecular mechanisms of ferroptosis regulators and the ncRNAs involved in this process may therefore uncover novel therapeutic strategies and intervention targets for DR. This review systematically summarizes recent advances in understanding the regulatory roles of ncRNAs in ferroptosis during DR progression and discusses future research directions in this emerging field.