Abstract: Diabetic retinopathy (DR) is one of the most common microvascular diseases caused by diabetes, and it is also considered to be the main cause of the obvious loss of vision and even blindness in patients with diabetes in the late stage. The phosphoinositide 3-kinase/protein kinase B (PI3K/Akt) signaling pathway is one of the important regulatory mechanisms for the body to maintain normal physiological functions. It participants in biological processes such as metabolism, inflammation, and cell proliferation in the body. In recent years, many studies have found that the PI3K/Akt signaling pathway is also involved in the pathogenesis and development of DR by regulating retinal neovascularization, insulin resistance, oxidative stress, retinal nerve damage and inflammation. The proper regulation of PI3K/Akt signaling pathway can reduce retinal neovascularization, alleviate inflammatory response, control insulin resistance, relieve retinal nerve injury and oxidative stress, thereby take a preventive effect on DR. However, due to the complexity of the pathological process of DR, studing the various effects of this pathway on different tissues and cells at different stages of DR in order to activate or inhibit accurately and selectively, and ultimately effectively improve and treat various pathological changes of DR, is the direction we should strive for in the future.(Int Rev Ophthalmol, 2021, 45: 351-356)

Key words: diabetic retinopathy, phosphoinositide 3-kinase/protein kinase B signaling pathway, targeted therapy