This review examines the roles of lactate signaling and lactylation (epigenetic modification) in retinal physiology and disease, covering how dysregulation of these processes contributes to neovascularization, inflammation, and neurodegeneration in conditions such as diabetic retinopathy, age-related macular degeneration, autoimmune uveitis, and glaucoma.
The review synthesizes evidence that lactate functions beyond a metabolic waste product — acting as an intercellular signaling molecule, receptor ligand, and epigenetic regulator — and that disruption of retinal lactate homeostasis is mechanistically linked to major blinding diseases.
As a narrative review, it does not provide original clinical or experimental data, and causal relationships between lactylation and specific disease outcomes remain largely inferential at this stage.
Therapeutic strategies targeting lactate signaling pathways and lactylation may offer new avenues for treating retinal diseases; clinicians should watch for emerging trials targeting retinal metabolic reprogramming in diabetic retinopathy and AMD.
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