Vitreous exosomes and ocular regeneration: Emerging roles in intercellular communication, biomarkers, and therapeutic delivery

The vitreous humor is a gel-like substance that fills the vitreous cavity. Its function is to transmit light to the retina and to provide structural support. With aging or diabetic vitreopathy, vitreous detachment can lead to visual impairment, highlighting an urgent need for innovative diagnostics and therapies. Exosomes are nanovesicles of the intercellular space, composed of biomolecules such as RNA, lipids, and proteins. Exosomes play critical roles in both ocular physiology and pathology, including within the vitreous. Essentially, the vitreous fluid is an intermediary for the exchange of these vesicles. Exosomes through facilitating communication between retinal cells, influence cellular functions, and promote regeneration modulation of inflammatory responses, and ultimately play a key role in maintaining ocular health. This review synthesizes current evidence on vitreous exosomes as mediators of ocular homeostasis, disease biomarkers, and novel therapeutic vehicles.