Diabetic retinopathy mechanomedicine: a paradigm shift in disease understanding and Mmanagement_Chinese Journal of Ocular Fundus Diseases

Authors：

Wei Bingqian ¹ , Dou Guorui ¹ , Xu Feng ^2,3 ,  Wang Xin ¹

1. Department of ophthalmology, Eye Institute of PLA, Xijing Hospital, The Air Force Medical University, Xi’an 710032, China;
2. Bioinspired Engineering and Biomechanics Center, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, China;
3. Ministry of Education, Key Laboratory of Biomedical Information Engineering, School of Life Science and Technology, Xi'an Jiaotong University, Xi' an 710049, China;

Corresponding author：

Wang Xin, Email: miawang22@foxmail.com

Keywords：

Diabetic retinopathy; Retina biomechanics; Retina mechanobiology; Retina mechanodiagnostics; Retina Mechanotherapy; Review

DOI：

10.3760/cma.j.cn511434-20250414-00170

Video：

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Abstract Full text Figures/Tables Video References Cited by

Diabetic retinopathy (DR) is a common complication of diabetes that can lead to visual impairment or even blindness. Current treatments mainly rely on invasive methods, which carry the risk of complications, making early intervention crucial. In recent years, research has revealed that the mechanical microenvironment of the retina plays a key role in the development and progression of DR, involving cell migration, functional disorders, and changes in the extracellular matrix. Mechanobiological mechanisms, such as mechanical signal transduction and the Hippo/Yes-associated protein pathway, are gradually being uncovered. Mechanical diagnostic and therapeutic strategies, including optical coherence elastography, tissue engineering, and intelligent diagnostic systems, offer new directions for DR management. In the future, further integration of biomechanics and mechanobiology research is needed to build multi-scale mechanical models and explore the synergistic regulation mechanisms between mechanical and biochemical factors, aiming to achieve precise and personalized diagnosis and treatment of DR and ultimately improve patients’ visual outcomes.

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10. Terai N, Spoerl E, Haustein M, et al. Diabetes mellitus affects biomechanical properties of the optic nerve head in the rat[J]. Ophthalmic Res, 2012, 47(4): 189-194. DOI: 10.1159/000331990.
11. Chen K, Weiland JD. Discovery of retinal elastin and its possible role in age-related macular degeneration[J]. Ann Biomed Eng, 2014, 42(3): 678-684. DOI: 10.1007/s10439-013-0936-x.
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18. Pannicke T, Wurm A, Iandiev I, et al. Deletion of aquaporin-4 renders retinal glial cells more susceptible to osmotic stress[J]. J Neurosci Res, 2010, 88(13): 2877-2888. DOI: 10.1002/jnr.22437.
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21. Gomez-Cruz C, Fernandez-de la Torre M, Lachowski D, et al. Mechanical and functional responses in astrocytes under alternating deformation modes using magneto-active substrates[J/OL]. Adv Mater, 2024, 36(26): e2312497[2024-04-21]. https://pubmed.ncbi.nlm.nih.gov/38610101/. DOI: 10.1002/adma.202312497.
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25. 张颖, 王钰岚, 王楷群, 等. 基质刚度调节细胞-细胞外基质间黏附对肿瘤细胞迁移影响的模型研究[J]. 医用生物力学, 36(4): 604-611. DOI: 10.16156/j.1004-7220.2021.04.016.Zhang Y, Wang YL, Wang KQ, et al. Modeling study on the effect of matrix stiffness-regulated cell-extracellular matrix adhesion on tumor cell migration[J]. J Med Biomech, 2021, 36(4): 604-611. DOI: 10.16156/j.1004-7220.2021.04.016.
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