Diabetic retinopathy (DR) is a leading cause of blindness in working‐age adults worldwide, affecting up to 80% of patients who have had diabetes for more than 10 years. Biomarkers are measurable indicators that can be used to diagnose diseases or monitor their progression. In DR, biomarkers can be found in various structures of the eye, including the retina, vitreous, and aqueous humour.One of the most commonly used biomarkers in DR is glycated haemoglobin (HbA1c), which reflects long‐term blood glucose control. Elevated HbA1c levels are associated with an increased risk of developing DR, and strict glycemic control can help to prevent or delay its onset.Other biomarkers in DR include imaging techniques such as optical coherence tomography (OCT) and fundus photography, which can provide detailed images of the retina and allow for the detection of microaneurysms, haemorrhages, and exudates. OCT angiography (OCTA) can also visualize changes in retinal blood flow, which may be indicative of early DR.In addition to structural biomarkers, there are also functional biomarkers that can be used to evaluate visual function, such as contrast sensitivity and visual field testing. These measures are often used to monitor the progression of DR and assess the efficacy of treatment.Recent advances in biomarker research have led to the discovery of new markers for DR, including genetic markers, inflammatory markers, and metabolic markers. Genetic markers, such as single nucleotide polymorphisms (SNPs), have been associated with an increased risk of developing DR. Inflammatory markers, such as cytokines and chemokines, are elevated in the aqueous humour and vitreous of patients with DR and may contribute to the development and progression of the disease. Metabolic markers, such as advanced glycation end‐products (AGEs), are elevated in patients with DR and may play a role in the pathogenesis of the disease.Overall, biomarkers are an important tool in the diagnosis, monitoring, and management of DR. They may also help to improve our understanding of the disease and facilitate the development of new therapies. By identifying patients at high risk of developing DR, biomarkers may enable earlier interventions to prevent or delay the onset of vision loss.
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