{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T17:05:51Z","timestamp":1790960751977,"version":"4.1.0"},"reference-count":114,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of University and Research"},{"DOI":"10.13039\/501100005699","name":"University of Eastern Piedmont","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005699","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/04387x656","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antioxidants"],"abstract":"<jats:p>Diabetic retinopathy (DR) is a leading cause of vision loss worldwide and represents a complex neurovascular complication of diabetes mellitus driven by chronic hyperglycemia. Increasing evidence identifies oxidative stress\u2014defined as an imbalance between reactive oxygen species (ROS) production and antioxidant defenses\u2014as a central pathogenic mechanism linking metabolic dysregulation to retinal injury. The retina is particularly vulnerable to oxidative damage due to its high metabolic demand, elevated oxygen consumption, and abundance of polyunsaturated fatty acids. Hyperglycemia activates multiple interconnected biochemical pathways, including the polyol and hexosamine pathways, protein kinase C signaling, advanced glycation end-product formation, and lipid peroxidation, all of which converge on excessive ROS production and mitochondrial dysfunction. Growing attention has focused on oxidative stress biomarkers as tools to characterize DR severity and progression. Elevated systemic markers of lipid, protein, and DNA oxidation, together with impaired antioxidant capacity, correlate with disease stage, while oxidative biomarkers detected in aqueous and vitreous humor reflect localized retinal injury. Importantly, oxidative stress biomarkers are also associated with functional outcomes, including best-corrected visual acuity and diabetic macular edema. Integration of systemic and ocular oxidative biomarkers with clinical staging may improve risk stratification and support personalized therapeutic strategies in DR.<\/jats:p>","DOI":"10.3390\/antiox15040425","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T14:33:33Z","timestamp":1774622013000},"page":"425","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Oxidative Stress in Diabetic Retinopathy: Pathogenic Mechanisms, Biomarkers and Clinical Implications"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1505-6029","authenticated-orcid":false,"given":"Caterina","family":"Toma","sequence":"first","affiliation":[{"name":"Eye Clinic, University Hospital Maggiore Della Carit\u00e0, 28100 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Ferdeghini","sequence":"additional","affiliation":[{"name":"Eye Clinic, University Hospital Maggiore Della Carit\u00e0, 28100 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8810-4688","authenticated-orcid":false,"given":"Mohammad Mostafa","family":"Ola Pour","sequence":"additional","affiliation":[{"name":"Laboratory of Physiology, Department of Translational Medicine, Universit\u00e0 del Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7517-2574","authenticated-orcid":false,"given":"Sakthipriyan","family":"Venkatesan","sequence":"additional","affiliation":[{"name":"Laboratory of Physiology, Department of Translational Medicine, Universit\u00e0 del Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"De Cill\u00e0","sequence":"additional","affiliation":[{"name":"Eye Clinic, University Hospital Maggiore Della Carit\u00e0, 28100 Novara, Italy"},{"name":"Department of Health Sciences, Universit\u00e0 del Piemonte Orientale \u201cAmedeo Avogadro\u201d, 28100 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3012-259X","authenticated-orcid":false,"given":"Elena","family":"Grossini","sequence":"additional","affiliation":[{"name":"Laboratory of Physiology, Department of Translational Medicine, Universit\u00e0 del Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"101799","DOI":"10.1016\/j.redox.2020.101799","article-title":"Oxidative stress and diabetic retinopathy: Molecular mechanisms, pathogenetic role and therapeutic implications","volume":"37","author":"Kang","year":"2020","journal-title":"Redox Biol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1007\/s00125-017-4435-8","article-title":"Diabetic retinopathy: Hyperglycaemia, oxidative stress and beyond","volume":"61","author":"Hammes","year":"2018","journal-title":"Diabetologia"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"8458472","DOI":"10.1155\/2019\/8458472","article-title":"Perturbed Biochemical Pathways and Associated Oxidative Stress Lead to Vascular Dysfunctions in Diabetic Retinopathy","volume":"2019","author":"Mahajan","year":"2019","journal-title":"Oxid. 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