Diabetic retinopathy （DR） is a common microvascular complication of diabetes mellitus， and its characteristic pathological changes include microaneurysm formation， hemorrhagic focus formation， exudate deposition， and neovascular proliferation. Long-term hyperglycemic state can induce inflammatory response， oxidative stress， and overexpression of vascular endothelial growth factor （VEGF）， which destroys the blood-retinal barrier and promotes the progression of DR. Although the current clinical treatment methods （such as laser photocoagulation and anti-VEGF drugs） have certain effects， they still have limitations， and there is an urgent need to explore safer and multi-target intervention strategies. Recent studies have discovered that the nuclear factor （NF）-κB signaling pathway plays a key role in the pathological process of DR. This pathway affects the occurrence and development of DR by regulating the release of inflammatory factors， oxidative stress response， and angiogenesis. With the advantages of multi-component， multi-target and overall regulation， traditional Chinese medicine （TCM） has shown unique potential in the prevention and treatment of DR. Especially， its precise regulation of the NF-κB pathway has become a research hotspot. This article systematically reviews the mechanisms of action of NF-κB-related signaling pathways in DR， with focuses on the research progress in TCM single herbs and active ingredients， Chinese patent medicines， and TCM compound preparations in ameliorating DR by regulating the NF-κB pathway. This review aims to provide a theoretical basis and a transformation direction for the development of drugs for the prevention and treatment of DR.

OBJECTIVE To re-evaluate the use of systematic evaluation/meta-analysis of anti-VEGF drugs in the treatment of diabetic macular oedema(DME),aiming to provide evidence-based support for the clinical application of this medication.METHODS A comprehensive search was conducted across a range of databases,including CNKI,Wanfang data,VIP,CBM,PubMed,Web of Science,Embase,and Cochrane Library.The objective was to identify systematic evaluation/meta-analysis of anti-VEGF drugs for DME,with search time from the inception of the databases to March 2024.The report quality,methodological quality,and evidence quality were assessed by using PRISMA2020 statement,AMSTAR2 scale and GRADE tool.A comprehensive analysis of systematic evaluation/meta-analysis results was also conducted.RESULTS A total of 22 articles were included.According to the PRISMA2020 statement evaluation,13 studies provided relatively complete information(≥21 points),while 9 studies had information deficiencies(18-＜21 points).The AMSTAR 2 scale evaluation revealed that 21 studies had very low methodological quality,and one study had low methodological quality.The GRADE tool evaluation showed that out of 89 outcome indicators,28(31.46%)were classified as high-quality evidence,34(38.20%)as moderate-quality evidence,24(26.97%)as low-quality evidence,and 3(3.37%)as very low-quality evidence.The comprehensive quality analysis results demonstrated that,compared with laser photocoagulation,anti-VEGF drugs significantly enhanced the improvement in best-corrected visual acuity(BCVA),as well as significant change in retinal thickness at 1 and 6 months,and 1 and 2 years post-treatment,and also in BCVA and retinal thickness at 1,3,and 6 months post-treatment(P＜0.05).Compared with placebo,patients treated with anti-VEGF drugs showed significant improvement in BCVA after 1 year of treatment(P＜0.05).However,when compared with corticosteroid drugs,patients treated with anti-VEGF drugs exhibited a significant increase in retinal thickness after 6 months of treatment(P＜0.05).Compared with corticosteroid drugs,the incidence of adverse events related to the eyes,cataract formation and intraocular pressure were significantly decreased in patients treated with anti-VEGF drugs(P＜0.05).Compared with laser photocoagulation,the incidence of ocular adverse events was significantly decreased in patients treated with anti-VEGF drugs,while the incidence of fatal adverse events was significantly increased(P＜0.05).CONCLUSIONS Anti-VEGF therapy for DME may possess certain advantages in terms of efficacy and safety,but it is associated with a higher risk of fatal adverse events;the evidence included in systematic reviews/meta-analyses is of moderate to high quality.