Human retinal organoids: from developmental biology to translational applications

Human retinal organoids (ROs), derived from pluripotent stem cells, have emerged as versatile human-relevant systems for studying retinal development, modeling disease, and evaluating therapeutic strategies. This review summarizes the evolution of human RO technology, from early stem-cell-based differentiation protocols to advanced culture platforms that improve scalability, reproducibility, and functional maturation. We compare human ROs with native human retinas regarding developmental trajectory, cellular composition, and photoreceptor function, while also highlighting persistent gaps in vascularization, immune interactions, and inner-retinal connectivity. ROs have displayed substantial value in modeling inherited retinal disorders, toxic and infectious retinopathies, and selected pathogenic processes relevant to complex diseases. Applications in precision medicine include patient-specific drug testing, gene augmentation, antisense approaches, and gene/base-editing validation. In regenerative medicine, RO-derived photoreceptors and retinal sheets are promising donor sources, although clear clinical evidence of functional integration remains limited. Current limitations include the lack of a bona fide fovea, incomplete recapitulation of the outer retina-retinal pigment epithelium-choroid interface, and variability across protocols and cell lines. Emerging bioengineering strategies, coculture systems, and multilineage assembloids are starting to address these barriers. Overall, human ROs are advancing rapidly as a platform that bridges developmental biology and translational ophthalmology, while still requiring careful interpretation of their biological scope and clinical readiness.