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Recent evidence implicates ceramides\u2014bioactive sphingolipids\u2014as critical mediators in DR pathogenesis. These lipids influence critical cellular processes, including apoptosis, inflammation, and oxidative stress. Emerging data suggests that ceramide accumulation exacerbates retinal neurodegeneration in DR by modulating key molecular pathways. This review synthesizes current knowledge on the role of ceramides in DR development and progression, examines the factors influencing their activity, and explores the therapeutic potential of targeting ceramide metabolism. 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