Abstract:Diabetic retinopathy(DR)is the most prevalent microvascular complication associated with diabetes mellitus(DM). Its pathological mechanisms encompass various factors, including microvascular lesions, chronic inflammation, oxidative stress, and metabolic memory effects. Nevertheless, current clinical practices in the diagnosis and treatment encounter significant challenges, particularly regarding early detection and the limited efficacy of therapeutic interventions. Recently, RNA methylation modifications, particularly N6-methyladenosine(m6A), have emerged as a central mechanism in the epigenetic regulation of the transcriptome, playing a crucial role in the pathophysiological processes underlying DR. The regulation of m6A modification is a synergistic process involving methyltransferases(such as METTL3), demethylases(such as FTO and ALKBH5), and binding proteins(such as the YTHDF family), which collectively influence RNA metabolism and participate in various pathological processes. Additionally, m6A interacts within a complex cooperative regulatory network alongside non-coding RNAs(including miRNA, lncRNA, and circRNA), significantly contributing to the key pathological mechanisms of DR. This article systematically reviews the existing literature, with the objective of constructing a regulatory network map for DR centered on RNA methylation. This review not only enhances the understanding of the pathogenesis of DR but also provides a theoretical foundation for developing novel diagnostic markers and targeted treatment strategies based on m6A.
