Abstract: Diabetic retinopathy (DR) is a common and serious complication in people with diabetes, severely affecting vision and even leading to blindness. However, the pathogenesis of DR has not been thoroughly elucidated. Recent studies have found that pyroptosis, as a novel form of programmed cell death, has played a key role in the pathogenesis of DR. The molecular pathways of pyroptosis in the pathogenesis of DR, covering multiple levels such as inflammatory response, oxidative stress, and cell signaling, and identify multiple key pathways, such as mitochondrial dysfunction, ROS accumulation, and Fas/FasL signaling axis, which lead to retinal cell degeneration. Therapeutic strategies focus on targeting pyrotosis modulators, including caspase inhibitors, mitochondrial stabilizers, and Bcl-2 family proteins, to prevent retinal cell death. Additionally,moduating oxidative stress, inflammatory response, and autophagy are potential therapeutic approaches, The developing targeted therapies that specifically modulate these pathways, as well as gene therapies and small molecule inhibitors, could provide promising therapies to prevent the progression of diabetic retinopathy. (Int Rev Ophthalmol, 2025, 49:  45-50)

Key words: diabetic retinopathy, pyroptosis, inflammatory response