Metabolic Deficiencies in the Vitreous of Diabetic Retinopathy: Exploring the Potential of Dietary Supplementation to Address Key Metabolite Imbalances.

Purpose: This study aimed to investigate the metabolic alterations in the vitreous humor of patients with diabetes across different stages of diabetic retinopathy (DR) and explore potential dietary interventions to mitigate these changes.

Patients and methods: Vitreous samples were collected from 23 patients undergoing vitrectomy and grouped into controls, diabetic without DR, non-proliferative DR (NPDR), and proliferative DR (PDR). Metabolomic analysis was performed using mass spectrometry, focusing on identifying significantly altered metabolites.

Results: A total of 82 features were identified, of which several were significantly reduced in DR compared to controls. Ascorbate and taurine were notably lower in NPDR (p < 0.01), while choline and N-acetylaspartic acid were significantly reduced in NPDR and PDR (p < 0.01). Tagatose was significantly reduced in PDR (p < 0.05), while stachydrine and serine displayed biphasic trends, decreasing in NPDR (p < 0.001; p < 0.05) but increasing in PDR (p < 0.05).

Conclusion: The results suggest that key metabolites involved in antioxidant defense, membrane integrity, and neuronal function are disrupted in the vitreous humor of patients with DR. Dietary supplementation targeting these metabolic deficiencies, such as increased intake of ascorbate, taurine, serine, choline, and stachydrine, may offer adjunctive support in managing DR progression.