The Role and Diagnostic Potential of Insulin-like Growth Factor 1 in Diabetic Retinopathy and Diabetic Macular Edema.

Diabetes mellitus (DM) is a chronic metabolic disorder that results in hyperglycemia, leading to multiple microvascular and macrovascular complications, including significant ocular damage resulting in the development of diabetic retinopathy (DR) and diabetic macular edema (DME). Many factors contribute to the pathogenesis of DR and DME, including hyperglycemia-mediated vascular and neuronal abnormalities and local and systemic inflammation. Growth hormone (GH) and insulin-like growth factor-1 (IGF-1) have been implicated in the initiation and progression of DR and DME through a variety of mechanistic processes. In this review, we provide a comprehensive synopsis of the diverse roles and molecular pathways supporting IGF-1 in the pathogenesis of DR and DME, elucidating its range of effects from detrimental to protective, depending on the context and stage of disease. We further investigate the underlying inflammatory processes regulated by IGF-1 and examine how the interaction of IGF-1 with key signaling molecules influences these inflammatory mechanisms. Additionally, the potential of serum IGF-1 as a biomarker for the progression of DR and DME in clinical practice is discussed. Finally, we consider current therapeutic approaches for DR and DME in relation to IGF-1 and explore novel therapeutic targets and innovative delivery methods. By providing an in-depth understanding of IGF-1's role in the pathogenesis and progression of DR and DME, this review underscores the diagnostic utility of serum IGF-1 and puts forth new treatment strategies to improve the management of DR and DME.