Integrated intraocular–plasma proteomics reveals conserved biomarkers for diabetic retinopathy progression: a multi-fluid biopsy study – published online 12/03/2026

Jiahui Cao, Fenghao Liu, Huiqian Kong, Chunran Lai, Zijing Du, Zhi Da Soh, Ting Su, Chenxiao Shen, Qinyi Li, Ying Fang, Yijun Hu, Xianwen Shang, Xiaotao Shen, Mingguang He, Ching‑Yu Cheng, Zhuoting Zhu, Meijuan Zhou, Xiayin Zhang, Honghua Yu

Monitoring the full spectrum of diabetic retinopathy—from early microscopic changes to advanced vision-threatening damage—has long been hindered by the lack of accessible, systemic biomarkers. In this issue, Cao, Liu and Kong et al (https://doi.org/10.1007/s00125-026-06708-3) leverage cutting-edge multi-omics to bridge this diagnostic gap, integrating high-throughput proteomics from intraocular fluid with large-scale plasma data. The investigation identifies neurofilament light chain (NFL) as a conserved biomarker of diabetic retinopathy originating from damaged retinal neurons and detectable in peripheral circulation. Longitudinal analysis using plasma proteomics demonstrates that plasma NFL not only predicts the incidence of diabetic retinopathy but also refines conventional risk models for broader microvascular and macrovascular complications. The authors conclude that using plasma NFL as a biomarker offers a minimally invasive window into the eye and systemic health, which could transform how clinicians monitor diabetes progression.