Aging and diabetic retinopathy: Inherently intertwined pathophysiological processes

Diabetic retinopathy (DR) is a leading cause of blindness worldwide and a costly complication of diabetes mellitus (DM). DR severity is associated with DM duration; thus, DR has become more devastating to individuals and healthcare systems owing to the aging population and the significantly increased human lifespan. Aging is an irreversible cellular state characterized by long-term stagnation of the cell cycle from excessive stress or damage. Furthermore, aging plays a critical role in developing age-related diseases, but its effects (direct or indirect) on DR development remain considerably understudied. Nonetheless, some studies have demonstrated that aging-related degeneration and DR development share common risk factors, which helps explain the increased prevalence of DR and visual impairment in the elderly population. This review aims to provide some conceptual insight into aging and DR development, two intertwined pathophysiological processes, and discusses potential therapeutic strategies for DR, including prevention and treatment, during this era of longevity.