Diabetic retinopathy (DR), a prominent microvascular impairment arising from diabetes, causes substantial visual dysfunction. Emerging evidence indicates that intestinal dysbiosis promotes DR progression via the gut-retina axis. Short-chain fatty acids serve a critical function in regulating gut microbiota, and propionate, a vital member of them, has potential translational value in DR prevention and management through the gut-retina axis. This review summarizes the impact of propionate on the retinal microenvironment by regulating gut microbiota and metabolites, focusing on its mechanisms influencing DR development, including modulating inflammation, protecting blood vessels, regulating immunity, exerting neuroprotection, and combating oxidative stress. It provides insights for devising propionate-based therapeutic strategies against DR.
Gao et al. (2026) studied this question.