外泌体是由细胞分泌的小细胞外囊泡，携带许多生物分子，例如mRNA、微小RNA、蛋白质和转录因子等。外泌体在生理过程中发挥介导细胞间通讯的功能；在病理状态下，可以介导内皮细胞损伤、血管炎症和血-视网膜屏障(BRB)功能障碍等病理过程，在糖尿病视网膜病变(DR)的进展中发挥重要作用。循环外泌体来源广泛，与眼部及全身的基础代谢状态密切相关，其内容物含有大量生物学信息，可作为DR早期诊断标志物的来源；糖尿病状态下，循环外泌体参与运输炎性因子和血管生成因子，通过激活内皮细胞进而破坏BRB，可能作为DR新的治疗靶点；眼内各种细胞通过分泌外泌体的方式调节细胞增生和血管生成，视网膜色素上皮细胞来源的外泌体可在体外促进血管生成，有助于揭示DR新生血管病变机制。本文对外泌体在DR的发病、诊断和治疗等方面的研究进展进行综述，为深入理解DR的发病机制和诊治提供全新的思路。“,”Exosomes are small extracellular vesicles secreted by cells and carry many biological molecules, such as mRNA, microRNA, proteins, and transcription factors.Exosomes play a role in mediating intercellular communication in normal physiological processes.In the pathological state, they can mediate pathological processes, such as endothelial cell damage, vascular inflammation, and blood-retinal barrier (BRB) dysfunction.Exosomes play an important role in the progress of diabetic retinopathy (DR). With a wide range of sources, circulating exosomes are closely related to the basic metabolic state of the eye and the body.They have many biological information and can be used as a source of early diagnosis markers for DR.In the diabetic state, circulating exosomes are involved in the transport of inflammatory factors and angiogenic factors, which activates endothelial cells and thereby destroys the BRB.Exosomes might be a new therapeutic target for DR.Eye-derived cells are involved in cell proliferation and angiogenesis by secreting exosomes.Retinal pigment epithelial cell-derived exosomes can promote angiogenesis n in vitro, helping to reveal the mechanism of DR neovascularization.This article reviews the relationship between exosomes and DR diagnosis, pathogenesis, and treatment, which may provide a new insight into the pathogenesis and treatment strategy of DR.n